加速康复外科理念在老年结直肠癌患者围手术期护理中的应用研究

Application of enhanced recovery after surgery (ERAS) in older patients with colorectal cancer

目的探讨加速康复外科理念(ERAS)在老年人结直肠癌围手术期护理中的应用价值。方法选择2018年3月至2018年10月本院胃肠外科收治的68例接受择期结直肠癌手术的老年患者为研究对象,采取随机数字表法分为对照组和ERAS组,每组各34例。对照组实施常规护理,ERAS组由加速康复团队对患者进行ERAS护理干预。记录两组术中出血量、手术时间、淋巴结清扫枚数、术后首次肛门排气时间、首次排便时间、住院时间和住院期间术后并发症(如切口感染、切口脂肪液化、吻合口漏、肺部感染、尿路感染等)情况。结果两组术中出血量、手术时间、淋巴结清扫枚数比较,差异均无统计学意义(均P>0.05);ERAS组术后肛门首次排气时间、首次排便时间和术后住院时间均短于对照组,差异有统计学意义(均P<0.001);两组术后并发症发生率比较差异均无统计学意义(均P>0.05)。结论加速康复外科理念可减轻围手术期的应激反应,促进老年结直肠癌患者术后恢复,缩短住院时间。

Objectives To investigate the effect of enhanced recovery after surgery (ERAS) in older patients with colorectal can cer. Methods Sixty-eight older patients who received elective surgery for colorectal cancer in the Department of Gastrointestinal Surgery of The First People’s Hospital of Shunde between March and October 2018 were recruited. They were randomly as signed to control group and ERAS group. Patients in the control group received routine nursing, and those in the ERAS group received nursing care based on ERAS. The followings were recorded: intraoperative blood loss, duration of surgery, lymph node yield, time to firstbowel movement, time to first defecation time to discharge, and postoperative complications during hospitaliza tion such as wound infection, fat necrosis, anastomotic leakage, lung infection, and urinary tract infection. Results There was no significant difference between the two groups in intraoperative blood loss, duration of surgery, lymph node yield and incidence of postoperative complications ( P > 0.05). The ERAS group had significantly shorter time to first bowel movement, time to first defe cation, and time to discharge than the control group ( P < 0.001). Conclusion Nursing care based on ERAS can reduce perioper ative stress reaction, promote patients’recovery and shorten hospitalization in older patients with colorectal cancer.