加速康复外科促进腹腔镜辅助胃癌根治术后患者康复

ERAS promotes recovery of patients after laparoscopic-assisted radical gastric cancer surgery

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)对腹腔镜辅助胃癌根治患者术后康复的影响.方法回顾性分析2018年1月-2020年12月120例行腹腔镜辅助胃癌根治术患者的临床资料.根据是否采用ERAS,分为ERAS组(n=62)和常规组(n=58),比较两组患者各项临床资料.结果两组患者的一般资料、术后并发症发生率等指标比较差异无统计学意义(P>0.05).ERAS组首次通气时间、术后排便时间及住院时间皆显著低于常规组(P<0.05).两组患者术后1 d前白蛋白水平均有下降,随后逐步升高,其中术后7 d ERAS组前白蛋白水平显著高于常规组(P<0.05).两组患者术后CRP水平皆有升高,但术后各时间点ERAS组CRP水平皆显著低于对照组(P<0.05).结论ERAS可改善腹腔镜辅助胃癌根治患者的营养状况,减少手术创伤应激反应,从而促进患者的快速康复.

Objective To investigate the effect of enhanced recovery after surgery(ERAS)on the efficacy of patients after laparoscopic-assisted radical gastric cancer surgery.Methods A retrospective study of 120 patients who underwent laparoscopic-assisted radical gastrectomy from January 2018 to December 2020 was performed.All patients were divided into 2 groups,ERAS group(n=62)and routine group(n=58),according to whether ERAS was carried out or not.The clinical data were compared between the two groups.Results There were no significant differences in general clinical data and incidence of postoperative complications between the two groups(P>0.05).The first flatus and defecation time after surgery and hospitalization time in the ERAS group was less than that in the routine group(P<0.05).Prealbumin levels in both groups decreased 1 d after surgery,and then gradually increased,with ERAS group significantly higher than routine group at 7 d after surgery(P<0.05).Postoperative CRP levels were increased in both groups,but the CRP levels in ERAS group were significantly lower than those in routine group at all postoperative time points(P<0.05).Conclusion ERAS could improve the nutritional status and reduce surgical traumatic stress response,thereby promote rapid recovery of patients undergoing laparoscopic assisted radical gastrectomy.