基于快速康复外科理念的多学科合作模式镇痛管理在胃肠肿瘤患者中的应用研究

Application of multi-disciplinary team analgesia management based on the concept of fast track surgery in patients with gastrointestinal tumors

目的探讨基于快速康复外科(FTS)理念的多学科合作模式(MDT)镇痛管理在胃肠肿瘤患者中的应用效果。方法选取2017年6月~2019年6月需行手术治疗的胃肠肿瘤患者150例作为研究对象。根据随机数字表法将患者分为对照组和观察组,每组75例。对照组患者采用传统镇痛管理模式进行干预,观察组患者采用基于FTS的MDT镇痛管理模式进行干预。观察两组患者术中情况(手术时间、术中出血量)、术后情况[术后6、24、72h时的数字评价量表(NRS)评分,术后首次下床活动时间、术后首次排气时间、术后首次经口进食时间、术后住院时间]和并发症发生率情况。结果两组患者手术时间、术中出血量比较,差异均无统计学意义(P>0.05)。观察组患者术后6、24、72h时NRS评分均低于对照组,术后首次下床活动时间、术后首次排气时间、术后首次经口进食时间、术后住院时间均少于对照组,差异均有统计学意义(P<0.05)。两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论基于FTS的MDT镇痛管理模式可有效减轻患者术后疼痛,促进患者术后恢复,且具有较好的安全性。

Objective To explore the application effect of multi-disciplinary team MDT analgesia management in gastrointestinal tumor patients based on the fast track surgery(FTS)concept.Methods 150 patients with gastrointestinal tumors requiring surgical treatment from June 2017 to June 2019 were selected and randomly divided into the control group and the observation group according to the random number table method,with 75 cases in each group.Patients in the control group were treated with traditional analgesia management mode,while patients in the observation group were treated with MDT analgesia management mode based on FTS.Intraoperative conditions(operative time and intraoperative blood loss),postoperative conditions(NRS score at 6h,24h and 72h after surgery,postoperative first time of getting out of bed,exhaust,and oral feeding,and postoperative hospital stay),and incidence of complications in the two groups were observed.Results There was no statistically significant difference in operative time and intraoperative blood loss between the two groups(P>0.05).The NRS score of the observation group was lower than that of the control group at 6,24 and 72h after surgery,and the first time of postoperative activity out of bed,exhaust,oral feeding and postoperative hospital stay were all lower than those of the control group,with statistically significant differences(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion MDT analgesic management model based on FTS can effectively reduce postoperative pain and promote postoperative recovery of patients,and has a good safety.