食管癌患者应用快速康复外科治疗的安全性及有效性分析

The safety and efficiency of fast track surgery application for patients with esophagogartrectomy

目的:探讨快速康复外科(FTS)技术在食管癌患者围手术期应用的安全性和有效性。方法:将入选的56例接受择期手术的食管癌患者随机分为对照组(27例)和FTS组(29例)。对照组采用传统的围手术期处理方案;FTS组采用快速康复的新型围手术期处理方案,主要措施包括缩短患者术前禁食时间、术前口服含碳水化合物的液体、术中维持患者体温、控制补液量、非常规留置腹腔引流、术后早期肠内营养支持、早期下床活动和采取有效的镇痛措施等。结果:与传统对照组相比,FTS组术后住院时间及静脉输液时间明显缩短,治疗费用减少,术后肠道排气时间提前,术后体质量下降减少,差异均有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论:FTS技术治疗围手术期食管癌患者是安全、有效的,可加快肠道功能恢复、减少治疗费用、缩短住院时间,促进患者早期康复。

Objective： To investigate the feasibility and safety of fast track surgery pathway for esophageal tumor resection patients.Methods： Fifty and six patients with esophageal carcinoma who underwent esophagogartrectomy were randomly divided into two groups： control group（n=27） and fast track group（n=29）.The patients in control group received conventional perioperative care,while those in the FTS group underwent fast track clinical pathway.FTS included shorten preoperative fasting time,preoperative oral carbohydrate;intraoperative temperature maintenance,fluid infusion control and nol use of abdominal drainage;early postoperative ambulation,enteral nutrition and potent analgesia,etc.Results： Compared with control group,FTS group was associated with significantly shorter postoperative hospital stay and duration of intrvenous infusion,less medical cost and earlier postoperative passage of flatus and defecation,loss of body weight was less in FTS group（P0.05）.There was no significant difference in morbidity or mortality between the two groups.Conclusions： FTS′ application of esophagogartrectomy is safe and efficient,and it can shorten postoperative hospital stay,reduce medical cost and accelarate recovery of gastric functions.