快速康复外科在直肠癌手术患者的应用

Application of fast track surgery in patients undergoing surgery for rectal cancer

目的探讨快速康复外科在直肠癌手术中的应用价值。方法符合入组条件的60例直肠癌患者随机均分为快速康复组(A组)和传统治疗组(B组)。A组快速康复外科措施包括:(1)术前进流质1d,口服泻剂,不灌肠;(2)术前4h一次性口服能量液体,例如糖水250ml;(3)术前不留置胃管和导尿管;(4)术后第1天进流质后,限制性补液,补液量2000-2500ml。比较术后第1天白细胞计数、术后首次排气时间、术后住院天数和并发症发生率等指标。结果与B组比较,A组术后第1天白细胞计数低[(10.50±1.56)×109/L vs.(13.04±2.53)×109/L](P<0.05),排气时间早[(2.5±0.6)d vs.(3.8±0.7)d](P<0.05),住院时间短[(9.1±2.9)d vs.(11.6±3.5)d](P<0.05),并发症发生率低(10.0%vs.30.0%)(P<0.05)。结论在直肠癌手术中合理应用快速康复外科措施可以促进患者肠道功能恢复,减少并发症和住院时间。

Objective To investigate the value of fast track surgery in the patients undergoing rectal cancer surgery .Methods Sixty patients with rectal cancer were randomized into two groups of A（treated with fast track surgery ,30 cases） and B（treated with conventional surgery ,30 cases） .The measures of fast track surgery included having liquid food and oral laxative ,but without enema one day before operation ,drinking a liquid with energy such as sugar water 250 ml ,not inserting indwelling gastric tube and urine catheter before surgery ,and having liquid food and restrictively infusing fluid of 2000‐2500 ml on the first postoperative day .The white blood cell counting one day after operation ,the first time of flatus passage ,postoperative hospital stay and complications were compared between two groups .Results Compared to group B ,the patients in group A had less white blood cell counting [（10.50 ± 1.56） x 109/L vs .（13.04 ± 2.53 ） x109/L ]（ P〈0 .05 ） ,earlier passage of flatus [（2.5 ± 0.6） d vs .（3.8 ± 0.7 ） d ] （ P〈0 .05 ） ,shorter hospital stay [（9.1 ± 2.9 ） d vs .（11.6 ± 3.5 ） d ] （P〈0 .05） and lower incidence of complication （10.0% vs .30.0% ）（P〈0 .05） .Conclusion Fast track surgery in rectal cancer surgery can promote the recovery of bowel function ,reduce complications and hospital stay .