快速康复外科结直肠癌患者术后感染分析

Effect of fast-track surgery on postoperative infections in colorectal cancer patients

目的探讨快速康复外科(fast-track surgery,FTS)应用于结直肠癌患者围手术期中的效果,以降低术后感染率。方法选择2012年8月-2014年5月在肿瘤外科接受手术的92例结直肠癌患者为研究对象。将其随机分为两组,各46例;FTS组患者接受FTS处理;对照组患者围手术期接受传统方式处理,对比两组患者的感染率、疗效、并发症。结果术后FTS组血白细胞水平明显低于对照组,两组间差异有统计学意义(P<0.01);术后血清白蛋白、总蛋白等水平FTS组下降幅度明显低于对照组,差异有统计学意义(P<0.01);术后疗效FTS组明显优于对照组,差异有统计学意义(P<0.01);FTS组患者恶心呕吐、肺部感染、尿路感染的比例低于对照组(P<0.05);年龄、尿管放置时间长、卧床时间长、住院时间长、合并基础疾病是结直肠癌患者术后感染的主要影响因素。结论结直肠癌围手术期采取FTS措施,可以减轻患者不良情绪,提高综合疗效,降低术后感染发生率,有利于患者尽快康复。

OBJECTIVE To explore the effect of fast‐track surgery used during the perioperative period of colorectal cancer surgery so as to reduce the incidence of postoperative infections .METHODS A total of 92 colorectal cancer patients who underwent the surgery in department of oncology from Aug 2012 to May 2014 were recruited as the study objects and randomly divided into two groups ,with 46 cases in each ;the patients in the FTS group was re‐ceived the FTS ,the patients in the control group was given the conventional treatment during the perioperative pe‐riod;the incidence of infections ,clinical efficacy ,and complications were observed and compared between the two groups .RESULTS The level of whiter blood cells of the FTS group was significantly lower after the treatment than that of the control group ,the difference was statistically significant （P〈0 .01）;the decrease of the level of post‐operative serum albumin or total protein of the FTS group was significantly lower than that of the control group , there was statistically significant difference（P〈0 .01）;the postoperative efficacy of the FTS group was signifi‐cantly better than that of the control group ,the difference was statistically significant （P〈0 .01） .The proportion of the patients with nausea and vomiting ,pulmonary infections ,or urinary tract infections was lower in the FTS group than in the control group （P〈0 .05） .The age ,long urinary catheter indwelling time ,long bedridden time , long hospitalization duration ,and complication of underlying disease were the leading influencing factors for the postoperative infections .CONCLUSION The implementation of FTS during the perioperative period of colorectal surgery can alleviate the adverse emotions of the patients ,raise the comprehensive efficacy ,reduce the incidence of postoperative infections ,and facilitate the recovery of the patients .