快速康复与营养支持在老年胃癌围手术期联合应用的临床效果

Clinical application of perioperative fast-track and nutrition support program in elderly patients with gastric cancer

目的评价围手术期快速康复与营养支持方案给老年胃癌患者联合应用后的临床效果。方法选取42例胃癌患者随机分为两组，每组21例，一组为应用快速康复外科方案的研究组，另一组为应用传统方法的对照组。比较两组术后首次排便时间、术后住院时间、住院总费用和术后并发症的发生率。结果研究组术后首次排便时间为（75．4±24．3）h，显著早于对照组的（98．0±22．6）h（P=0．0165）；研究组术后住院时间为（11．2±3．2）d，显著短于对照组的（14．4±4．6）d（P=0．0004）；研究组住院总费用为（3．66±0．48）万元，显著少于对照组的（4．56±0．78）万元（P=0．0001）。两组并发症的发生率差异具有统计学意义（9．5％比28．6％，P=0．0422）。结论围手术期应用快速康复外科方案可以明显加快老年胃癌患者的术后康复，缩短术后住院时间，降低医疗费用，减少术后并发症的发生率。

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery （FTS） program and nutrition support in the elderly patients with gastric cancer. Methods Totally 42 patients were equally randomized into FTS group （receiving perioperative FTS program） and control group （receiving a conventional therapy）. The postoperative first defecation time, postoperative hospital stay, hospitalization expenditure, and postoperative complications were compared between these two groups. Results The postoperative first defecation time and postoperative hospital stay were （75.4 ± 24. 3 ） hours and （ 11.2 ± 3.2） days in FTS group and （98.0 ± 22.6 ） hours and （ 14.4 ±4.6） days in control group （ P = 0. 0165, P = 0. 0004 ; respectively）. The hospitalization expenditure was significantly lower in FTS group than in control group [ （3.66 ±0.48） × 10^4 vs. （4. 56 ± 0. 78 ） × 10^4 RMB yuan ; P = 0. 0001 ]. The incidence of postoperative complications in FTS group was also significantly lower than that in control group （9.5 % vs. 28.6% , P = 0. 0422）. Conclusion Perioperative FTS program can accelerate postoperative rehabilitation, shorten hospital stay, lower hospitalization expenditure, and reduce the incidence of postoperative complications.