加速康复外科在原发性肝癌根治术中的应用研究

Enhanced recovery after surgery in radical resection of primary liver cancer

目的探讨加速康复外科在原发性肝癌根治术围手术期应用的安全性以及临床应用价值。方法采用前瞻性研究方法，将68例原发性肝癌患者随机分为加速康复外科的围手术期处理组（n=35，ERAS组）和传统围手术期处理组（n=33，对照组），比较两组术后恢复情况和术后1个月的非预期再住院率等指标。结果与对照组比较．ERAS组术中补液量明显减少（t=2．812，P〈0．05），术后24hVAS疼痛控制更理想（t=2．023，P〈0．05），术后首次排气时间明显缩短（t=2．354，P〈0．05），术后住院时间明显减少（t=2．056，P〈0．05），患者满意度显著提高（t=2．227，P〈0．05）；两组患者术后一般并发症和手术特有并发症比较，差异无统计学意义（χ^2=0．032，P〉0．05）。结论ERAS应用于原发性肝癌根治术安全有效，促进术后康复，缩短术后住院时间。

Objective To investigate the clinical value of enhanced recovery after surgery （ERAS） in radical resection of primary liver cancer. Methods In this study 68 patients were randomly assigned into the ERAS group （ n = 35 ）, and control group （ n = 33 ）. Results Comparing with control group, there was significant differences in ERAS group with less volume of intraoperative intravenous fluid （t = 2. 812, P 〈 0. 05）, lower visual analogue scale （VAS） scores （ t = 2. 023, P 〈 0. 05 ）, the shorter time to flatus （ t = 2. 354, P 〈 0. 05 ）, shorter postoperative hospital stay （ t = 2. 056, P 〈 0. 05 ）, and higher satisfaction degree of patients （ t = 2. 227, P 〈 0.05 ）, while there was no significant differences between the two groups in postoperative complications （X^2 = 0. 032, P 〉 0. 05 ）. Conclusion ERAS was safe and effective for patients undergoing radical resection of primary liver cancer.