早期进食对加速肝癌手术病人康复的影响

Study for the effect of enhanced recovery by early stage feeding for patients with liver cancer surgery

目的应用加速康复护理理念,探讨早期进食对加速肝癌病人术后康复的影响。方法将65例肝癌手术病人随机分成两组,早期进食组33例,常规进食组32例,分析比较两组病人术后肝功能、胃肠道功能恢复情况、感染率、并发症发生率、营养费用、睡眠质量及住院时间。结果两组肠鸣音恢复中位时间、肛门排气中位时间、首次排便中位时间比较差异有显著意义(P<0.05)。两组病人术后第1天肝功能指标差异无显著意义(P>0.05);术后第7天早期进食组谷丙转氨酶、谷草转氨酶和总胆红素指数均低于常规进食组,血浆总蛋白、血浆白蛋白、血浆球蛋白指数均高于常规进食组(P<0.05)。两组术后平均睡眠时间、胃肠道不适、感染率、并发症发生率、术后营养费用、住院时间比较差异有显著意义(P<0.05)。结论与常规进食相比,早期进食不增加并发症的发生,可减少胃肠道不适与感染率,促进肝功能和胃肠功能恢复,改善睡眠质量,降低营养费用,缩短住院时间。肝癌术后早期进食可加速病人术后康复。

Objective To study the effects of early stage feeding on enhanced recovery after liver cancer surgery by using fast track surgery. Method 65 liver cancer patients were divided into early-stage feeding group （n=33） and conventional feeding group （n=32）. The liver function after operation, bowel movement recovery duration, postop- erative infectious rate, postoperative morbidity, cost of nutritional support, sleep time per day and duration in-hos- pital were compared in the two groups. Result Gastrointestinal tract discomfort rate, infection rate, nutrition cost, bowel movement recovery duration and duration in-hospital in the patients of early-stage feeding group were signifi- cantly lower than those in conventional feeding group （P〈0.05）, sleep time per day in patients of early-stage feeding group were significantly longer than those in conventional feeding group（P〈0.05）, and recovery of liver function for patients of early-stage feeding group were significantly better than those in conventional feeding group. There were no significant difference in nutrition parameter and morbidity between the two groups （P〉0.05）. Conclusion Early-stage feeding could enhance recovery after operation. Compared with conventional feeding, early-stage feeding could decrease gastrointestinal tract discomfort rate and infection rate, accelerate recovery of liver function and bowel function, improve the sleep quality, low down the nutrition cost, decrease time in hospital, and do no influence to morbidity risk.