老年胃肠恶性肿瘤患者术后医院感染应用快速康复外科理念的观察

Observation the Application of Fast Track Surgery in Postoperative Nosocomial Infection in Elderly Patients with Gastrointestinal Malignant Tumor

目的:探讨老年胃肠恶性肿瘤患者术后医院感染应用快速康复外科理念(FTS)的效果。方法:选取2015年1月-2016年3月拟于本院行切除治疗的老年胃肠恶性肿瘤志愿患者86例,按信封法随机分为FTS组(n=43)和传统组(n=43)。传统组行传统全胃切除术或腹腔镜结直肠癌切除术治疗,FTS组采用快速康复围术期处理方案进行全胃切除术或腹腔镜结直肠癌切除术治疗。统计比较两组住院期间感染发生率、术后下床活动时间、住院天数、术前和术后3个月的自测健康评定量表(SRHMS)得分及患者满意度。结果:与传统组比较,FTS组住院期间感染发生率较低,术后下床活动时间和住院天数均缩短,术后3个月的生理健康子量表和心理健康子量表得分及患者满意度均提高,差异均有统计学意义(P<0.05)。两组术后3个月的生理健康子量表和心理健康子量表得分亦均高于术前,差异均有统计学意义(P<0.05)。结论:FTS应用于老年胃肠恶性肿瘤患者围术期有助于减少其术后医院感染的发生,促进患者康复并改善患者满意度,值得临床推广。

Objective： To investigate the effect of fast track surgery （ FTS ） on nosocomial infection in elderly patients with gastrointestinal malignancy.Method： 86 patients who bad scheduled to undergo resection in our hospital from January 2015 to March 2016 were selected, they were divided into FTS group and traditional group according to envelope method, 43 cases in each group.The traditional group had given traditional gastrectomy or laparoscopic resection of colorectal cancer treatment, FTS group had used rapid rehabilitation perioperative treatment program for total gastrectomy or laparoscopic resection of colorectal cancer.The incidence of infection, the time began to activity off-bed, the number of hospital days, the preoperative and postoperative 3 months self -rated health rating scale （ SRHMS ） scores and patient satisfaction had compared between the two groups.Result： Compared with the traditional group, the rate of infection in FTS group was reduced, the time began to activity off-bed and the days of hospitalization were shortened, the physical health subscale of 3 months and mental health subscale scores and patient satisfaction were improved, the differences were statistically significant （/~〈0.05 ） .The scores of physical health subscale and mental health subseale of the two groups were also higher than those before operation, the differences were statistically significant （ P〈0.05 ） .Condusiorl： FTS used in elderly patients with gastrointestinal cancer perioperative help to reduce the incidence of postoperative hospital infection, promote patient recovery and improve patient satisfaction, worthy of clinical promotion.