加速康复手术综合治疗模式在结直肠癌患者的应用

Application of accelerated rehabilitation surgery in treatment of patients with colorectal cancer

目的探讨加速康复应用于结直肠手术的安全性与有效性。方法选取2013年3月至2014年11月,在本院收治的结直肠癌患者100名,按随机法分为2组。一组在加速康复外科手术综合治疗模式理念指导下进行结直肠癌手术,本组患者50例(加速康复外科组);另一组在传统围术期处理理念下行结直肠癌手术治疗,本组患者50例(对照组)。比较两组患者手术指标、临床指标及实验室指标。结果加速康复外科组患者术中出血量(123.32±42.17)ml,切口长度(10.2±2.1)cm,手术时间(182.24±38.21)分钟,与对照组相比,差异无统计学意义(P>0.05)。加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;加速康复外科组术后3天外周血PCT(76.8±23.7)mg/d,停止输液时间(3.1±1.1)天,出院时间(5.2±0.8)天,两组相比,差异有统计学意义(P<0.05)。结论加速康复外科手术综合治疗的患者术后恢复更快,具有临床推广价值。

Objective To investigate the safety and effectiveness of the accelerated rehabilitation surgery routinely used in comprehensive treatment model as the safety and effectiveness ofin the colorectal surgery. Methods March 2013 to November 2014 in our hospital, 100 patients with colorectal cancer, according to a random number table were randomly divided into two groups, each 50 pattients. In fast track surgery group, A group of accelerated rehabilitation surgery combined modality treatment of colorectal cancer surgery were performed philosophy under the guidance of this group of50 patients（fast track surgery group）;. In another control group in, the traditional concept of perioperative surgical treatment of colorectal cancer downsidewere performed, this group 50 patients（control group）. Two groups were compared The surgery indicators, clinical indicators and laboratory parameters were compared. Results The surgical blood loss accelerated rehabilitation group was 123.32±42.17 ml, compared incision length was 10.2±2.1cm, operative time 182.24±38.21 min in the accelerated rehabilitation group,compared with the control group, the differences wereas not statistically significant（P〈0.05）. Accelerate the rehabilitation of patients after surgical bed time was 1.2±0.8d, flatus was 2.7±1.2d, postoperative complication rate of wasf 2.5% in the accelerated rehabilitation group, compared with the control group, the difference was statistically significant（P〈0.05）. The control group after three days in Pperipheral blood PCT after three days in the control group was 215.32±145.21 mg / d L;, which was higher than that in the accelerated rehabilitation group（76.8±23.7 mg/d L）（P〈0.05）after surgery group three days in peripheral blood PCT 76.8±23.7 mg / d,. Sstop the infusion time of was3.1±1.1d, discharge time is was 5.2±0.8d in the accelerated rehabilitation group, two compared to the control group, the difference was statistically significant（P〈0.05）. Conclusion Compared with the traditional concept of guidance downward colorectal cancer surgery, the patients treated with accelerate the rehabilitation surgery recovered faster, had less postoperative inflammation and immune changes.