快速康复外科对胃癌手术患者临床指标及术后并发症的影响

The efficacy of fast track surgery gastrectomy on clinical indicators and postoperative complications in the gastric cancer patients after radical operation

目的探讨在快速康复外科理念指导下的胃癌根治术的临床应用,比较快速康复外科对胃癌患者行胃癌根治术后临床指标及术后并发症的影响。方法选取2013年11至2014年11月在本院快速康复外科理念指导下进行胃癌根治术的40例胃癌患者作为研究对象(快速康复外科组),并选取同期在传统理念指导的下行胃癌根治术治疗的40例胃癌患者的临床资料作为对照组一并纳入对照分析。比较两组患者手术指标、临床指标及实验室指标。结果快速康复外科组患者术中出血量(123.32±42.17)ml,切口长度(9.2±1.1)cm,手术时间(243.24±18.21)分钟,与对照组相比,差异无统计学意义(P>0.05)。快速康复外科组患者术后下床时间(1.2±0.8)天,肛门排气时间(2.7±1.2)天,术后切口感染并发症发生率2.5%,与对照组相比,差异有统计学意义(P<0.05)。对照组术后3天外周血PCT(215.32±145.21)mg/d L;快速康复外科组术后3天外周血PCT(76.8±23.7)mg/d,两组相比,差异有统计学意义(P<0.05)。结论与同期在传统理念指导下行的胃癌根治术的患者相比,快速康复外科理念指导治疗下的患者术后恢复更快,术后炎症水平及免疫改变更小,有利于患者的预后,具有临床推广价值。

Objective To explore the concept of fast track surgery gastrectomy under the guidance of clinical applications, and the efficacy on clinical indicators and postoperative complications relatively fast track surgery foin ther gastric cancer patients with gastric cancer after radical operation of clinical indicators and postoperative complications. Methods 40 cases of whith gastric cancer after radical gastrectomy from Novemberin 2013 11-to November 2014 were applied with November fast track surgery in our hospital, under the guidance of the concept of radical gastrectomy as research subjects（fast track surgery group）,）. and40 patients were selected in the same period in the traditional concept of guidance downward gastrectomy the clinical data of40 patients with gastric cancer treatment be included, as a control group were compared. Two groups were compared s The surgery indicators, clinical indicators and laboratory parameters were compared between the two groups. Results Compared with control group, Patients with rapid the blood loss was surgical rehabilitation group（123.32±42.17）ml, compared with no significant difference（P〉0.05） incision length（was 9.2±1.1）cm, operative time（was243.24±18.21）min in the fast track surgery group, the difference was statistically significant（P〈0.05） with the control group. In the fast track surgery group,Rapid rehabilitation of patients after surgical the bed time was 1.2 ± 0.8d, flatus was 2.7 ± 1.2d, postoperative complication rate of was 2.5%, compared with the control group, the difference was statistically significant（P〈0.05）. The control group The after three days in peripheral blood PCT after three days in the control group（was 215.32±145.21）mg/d L;, which was higher in fast track surgery group after three days in peripheral blood PCT（（76.8±23.7）mg/d L）, compared the two groups, the difference was statistically significant（P〈0.05）. Conclusions C ompared with In patients with the traditional concept of guidance downward radical gastrectomy compared with the same period, the patients with rapid rehabilitation recovery faster, had less of patients after surgical treatment under the guidance of the concept of faster recovery, postoperative inflammation and immune changes in the level of less conducive prognosis, with clinical value.