快速康复联合改良空肠间置术在老年食管胃结合部癌中的应用研究

Application effects of quick rehabilitation combined with improved jejunum interposition operation in treatment of the adenocarcinoma of esophagogastric junction in the elderly

目的探讨快速康复联合改良空肠间置术在老年食管胃结合部癌中应用的安全性及可行性。方法选择2017年1月至2019年1月收治的42例>65岁的食管胃结合部癌手术患者,随机分为传统治疗组22例和快速康复(ERAS)组20例,均行根治性近侧胃大部切除、改良空肠间置术,比较患者手术并发症及术后恢复情况。结果患者手术均成功,ERAS组术中首次排气恢复时间、首次下床活动时间、住院时间均降低或缩短,差异有统计学意义(P<0.05);术后疼痛评分及术后3 d C-反应蛋白均降低或缩短,差异有统计学意义(P<0.05);2组患者术后并发症比较差异无统计学意义(P>0.05)。结论在老年食管胃结合部癌患者围手术期中应用ERAS中有助于加快患者恢复的措施及提高患者术后生活质量的手术方式,可以达到改善患者生命质量的目的。

Objective To investigate the safety and feasibility of quick rehabilitation combined with improved jejunum interposition operation in treatment of the adenocarcinoma of esophagogastric junction in the elderly.Methods A total of 42 elderly patients(>65 years)with esophagogastric junction cancer who underwent radical proximal gastrectomy and modified jejunal interposition operation in our hospital from January 2017 to January 2019 were enrolled in the study,who were randomly divided into traditional treatment group(n=22)and ERAS group(n=20).The postoperative complications and recovery status of patients were observed and compared between the two groups.Results All the operations were successful.The recovery time of the first exhaust,first out-of-bed activity time and and hospital stay in ERAS group were significantly decreased or shortened(P<0.05),moreover,the postoperative pain scores and C-reactive protein levels at 3 days after operation were significantly decreased(P<0.05),there were significant differences between the two groups(P<0.05).However there was no significant difference in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusion The application of ERAS in treatment of the adenocarcinoma of esophagogastric junction in the elderly is helpful to accelerate the recovery and improve the life quality of patients after operation.