快速康复治疗在胃肠道恶性肿瘤中的应用

Study on the application of minimally invasive surgery and fast-track surgery in gastrointestinal malignant tumor

目的探讨微创技术和快速康复外科治疗在胃肠道恶性肿瘤中的临床效果。方法将43例胃肠道恶性肿瘤患者分为A组(21例)和B组(22例)。A组采用传统常规治疗,B组采用快速康复治疗。比较两组临床效果,对患者进行5年随访观察。结果 B组手术时间、术中出血量、停止输液时间、体重差、肛门排气时间、切口愈合时间均少于A组,两组比较,差异有统计学意义(P<0.05)。术前两组血清白蛋白、CRP和血清Ig A比较,差异无统计学意义(P>0.05),术后上述指标比较,差异均有统计学意义(P<0.05)。A组术后并发症发生率为61.9%,明显高于B组27.3%,差异有统计学意义(P<0.05)。B组住院时间比A组短,治疗费用比A组少,两组比较,差异具有统计学意义(P<0.05)。随访5年,B组生存率明显高于A组,两组比较,差异具有统计学意义(P<0.05)。结论将微创技术和快速康复外科治疗应用在胃肠道恶性肿瘤的临床治疗中有积极的推广意义。

ObjectiveTo explore the clinical effect of minimally invasive surgery and fast-track surgery in the treatment of gastrointestinal malignant tumors. MethodsForty-three patients with gastrointestinal malignant tumors were divided into group A（21 cases） and group B（22 cases）. Group A were treated with conventional therapy; group B were treated with fast-track surgery. The clinical effect of the two groups were compared, and the patients were followed up for 5 years. ResultsThe operation time, intraoperative blood loss, stop infusion time, weight difference, anal exhaust time, wound healing time of group B were less than those of group A; the difference was statistically significant （P〈0.05）. Before operation, there was no significant difference in serum albumin, CRP and serum IgA between the two groups （P〉0.05）;After operation, the differences of the above indicators were statistically significant （P〈0.05）. The incidence of postoperative complications in A group was 61.9%, higher than 27.3% in group B; the difference was statistically significant （P〈0.05）. The hospitalization time of group B was shorter than that of group A, the treatment cost was less than that of group A;The difference between the two groups was statistically significant （P〈0.05）; After 5 years of follow-up, the survival rate of group B was significantly higher than that of group A（P〈0.05）. ConclusionThe application of minimally invasive surgery and fast-track surgery in the treatment of gastrointestinal malignant tumors have a positive significance to be popularized.