加速康复外科理念对胰腺癌胰十二指肠切除术患者临床预后的影响分析

Effect of accelerated rehabilitation program on prognosis of pancreatic cancer patients undergoing pancreaticoduodenectomy

目的探讨加速康复外科理念(enhanced recovery after surgery,ERAS)对胰腺癌胰十二指肠切除术(pancreatoduodenectomy, PD)患者临床预后的影响.方法选取天津市宝坻区人民医院自2015-01/2017-08收治的拟行PD的胰腺癌患者共计52例,采取随机数表发随机将患者分为两组,取得患者知情同意,分为ERAS组24例,传统策略组28例,所有患者诊断明确,PD,ERAS组患者按照ERAS治疗护理患者,传统组患者按照传统常规治疗护理,比较分析两组患者住院时间、术后消化道功能恢复时间、住院费用、胰瘘、胃排空延迟、腹腔出血或消化道出血、病死、再入院等各种并发症发生情况.结果 ERAS组患者术后住院时间、术后消化道功能恢复时间较传统组短,住院费用较传统组低,两组差异有统计学意义(P<0.05), ERAS组患者并发症发生率为45.83%,低于传统组75.00%,两组差异有统计学意义(P <0.05).结论 ERAS在胰腺癌PD患者的治疗中较传统方法治疗更为有效,安全性高,具有较高的可行性.

AIM To explore the effect of accelerated rehabilitation program on the prognosis of pancreatic cancer patients undergoing pancreaticoduodenectomy(PD).METHODS A total of 52 patients with pancreatic cancer who underwent PD from January 2015 to August 2017 at Tianjin Baodi People’s Hospital were selected and randomly divided into two groups to receive either enhanced recovery after surgery(ERAS;n=24)or traditional surgery(n=28).Patients in the ERAS group were given nursing care according to the concept of accelerated rehabilitation surgery,while patients in the traditional surgery group were given traditional routine care.Hospitalization time,time to postoperative recovery of gastrointestinal function,hospitalization cost,and complications including delayed pancreatic fistula,delayed gastric emptying,abdominal hemorrhage or gastrointestinal bleeding,death,and re-hospitalization were compared between the two groups.RESULTS Postoperative hospital stay and time to postoperative recovery of gastrointestinal function were significantly shorter in the ERAS group than in the traditional surgery group.The cost of hospitalization was significantly lower in the ERAS group than in the traditional surgery group(P<0.05).The incidence of complications in the ERAS group was 45.83%,which was significantly lower than that of the traditional group(75.00%;P<0.05).CONCLUSION Accelerated rehabilitation program is more effective than conventional strategy in pancreatic cancer patients undergoing PD,with high safety and feasibility.