食管癌根治术患者围术期快速康复治疗的效果评价及近期预后

Evaluation of efficacy and short-term prognosis of perioperative rapid rehabilitation therapy after radical esophagectomy for esophageal cancer

目的探讨食管癌根治术患者围术期快速康复治疗的效果评价及近期预后。方法选取2016年12月至2018年5月间空军军医大学收治的80例行食管癌根治术治疗的患者,根据治疗方式的不同分组,采用传统围术期护理的35例患者纳入对照组,采用围术期快速康复治疗的45例患者纳入康复组。比较两组患者治疗效果和术后恢复情况。结果两组患者治疗总有效率比较,差异无统计学意义(P>0.05)。康复组患者胸腔引流管留置时间、术后输液时间、术后肠内营养管留置时间、住院时间和住院费用均低于对照组患者,差异均有统计学意义(均P<0.05)。康复组患者免疫功能指标总淋巴细胞计数、CD4^+和Ig M均高于对照组,C反应蛋白含量低于对照组,术后焦虑自评量表评分和术后疼痛评分均低于对照组,康复组患者并发症发生率为33.3%,低于对照组的45.7%,差异均有统计学意义(均P<0.05)。结论食管癌根治术围术期进行快速康复治疗,效果较好,可减轻患者疼痛,降低术后并发症,利于预后恢复。

Objective To evaluate the efficacy and short-term prognosis of perioperative rapid rehabilitation therapy after radical esophagectomy for esophageal cancer.Methods A total of 80 patients who underwent radical esophagectomy at Second Affiliated Hospital of Air Force Military Medical University from December 2016 to May 2018 were ramodely sellected.Depending on the treatment,35 patients receiving traditional perioperative unrsing were included in the control group and 45 patients receiving rapid rehabilitation therapy were included in the rehabilitation group.The treatment efficacy and recovery in the two groups after operation were observed.Results There was no significant difference in the overall efficacy rate between the two groups(P>0.05).The pleural drainage catheter indwelling time,postoperative infusion time,enteral feeding tubes indwelling time,length of hospital stay and hospitalization costs were significantly lower in the rehabilitation group than in the control group(all P<0.05).The immune function indexes lymphocyte counts,and CD4^+and Ig M levels were significantly higher in the rehabilitation group than in the control group(all P<0.05).The C-reactive protein(CRP)was significantly lower in the rehabilitation group than in the control group(P<0.05).The postoperative self-rating anxiety scale(SAS)score and postoperative score were significantly lower in rehabilitation group than in control group(P<0.05).The incidence of complications in rehabilitation group was 33.3%,which was significantly lower than 45.7% in control group(all P<0.05).Conclusion Rapid rehabilitation therapy during perioperative period of radical esophagectomy for esophageal cancer has remarkable efficacy,which can relieve patients’pain,reduce postoperative complications and facilitate prognosis recovery.