摘要
目的探讨术后加速康复和疼痛管理在直肠癌患者围手术期的临床应用效果。方法选取2014年1月至2016年12月广东省人民医院行直肠癌根治术100例直肠癌患者,分别采用加速康复理念加疼痛管理和传统方法进行治疗,分为加速康复组(50例)和传统组(50例)。结果加速康复组与传统组相比,术后首次排气时间[(1.8±0.6)d比(3.4±0.6)d,t=-8.1,P〈0.001]、术后进食时间[(1.3±0.6)d比(3.2±0.6)d,t=-10.1,P〈0.001]、腹腔引流放置时间[(3.6±0.7)d比(5.3±0.8)d,t=-6.7,P〈0.001]、术后下床活动时间[(1.1±0.3)d比(2.7±0.5)d,t=-12.7,P〈0.001]均提前,术后住院时间减少[(4.6±0.6)d比(6.1±0.6)d,t=-7.7,P〈0.001],住院费用降低[(4.5±0.5)万元比(5.4±0.8)万元,t=-1.8,P=0.014]。两组手术前后疼痛评分相比差异有统计学意义(F=83.643,P〈0.001),术后并发症发生率相比差异无统计学意义(8%比10%,P〉0.05)。结论加速康复理念和疼痛管理在直肠癌根治术中应用有良好的临床效果。
Objective To explore the clinical effect of enhanced recovery after surgery and pain management during the perioperative period in rectal cancer patients. Methods 100 rectal cancer patients after radical resection were divided into ERAS group (50 cases ) and routine care group (50 cases ). Results Compare with the routine group, the time of ERAS group was shorter in postoperative bowel function recovery [(1.8±0.6)dvs. (3.4±0.6) d,t= -8.1, P〈0.001], oral feeding[(1.3±0.6)d vs. (3.2±0.6) d,t = -10.1, P〈0.001], intraperitoneal catheter drain[(3.6±0.7)d vs. (5.3 ±0.8) d,t= -6.7, P〈0.001] and mobilization[ (1.1±0.3)d vs. (2.7±0.5) d,t = -12.7, P〈 0.001]. ERAS group was associated with shorter hospital stay [(4.6±0.6)d vs. (6.1±0.6) d, t = -7.7, P 〈 0. 001 ], lower costs (P = 0. 014) , lower pain score at the time of 6 h, 12 h,24 h and 48 h after surgery ( P 〈 0. 001 ). There was no significant statistical difference in postoperative complication rate 8% and 10% (P = 1. 000). Conclusions ERAS management in rectal cancer patients after radical operation enhanced postoperative recovery.
作者
黎伟豪
冯兴宇
王俊江
罗志坚
黄成智
李胜
胡伟贤
吕泽坚
郑佳彬
姚学清
Li Weihao;Feng Xingyu;Wang Junjiang;Luo Zhijian;Huang Chengzhi;Li Sheng;Hu Weixian;Lyu Zejian;Zhen Jiabin;Yao Xueqing(Department of General Surgery, Guangdong General Hospital, Guangzhou 510515, China)
出处
《中华普通外科杂志》
CSCD
北大核心
2018年第4期314-317,共4页
Chinese Journal of General Surgery
基金
广东省人民医院院内专项基金资助项目(y012015338)
关键词
直肠肿瘤
疼痛管理
围手术期
加速康复外科
Rectal neoplasms
Pain management
Perioperative period
Enhanced recovery after surgery