加速康复外科策略在高龄胃癌腹腔镜术中的应用价值

Application value of enhanced recovery strategy after laparoscopic surgery for senile patients with gastric cancer

目的探讨加速康复外科(ERAS)策略在高龄胃癌腹腔镜术中的应用价值。方法回顾性分析2017年5月至2020年5月接受腹腔镜胃癌根治术治疗的87例老年胃癌患者资料,根据围术期是否采用ERAS策略分为ERAS组(42例)和传统组(45例)。采用SPSS 23.0统计分析软件,围术期相关指标、疼痛程度、营养风险等计量资料以(x±s)表示,独立t检验;并发症发生率比较采用χ^(2)检验。P<0.05为差异有统计学意义。结果两组术后并发症总发生率相比,差异无统计学意义(P>0.05)。ERAS组首次进食时间、肛门排气时间、首次下床时间、住院时间均比传统组短(P<0.05)。ERAS组术后6 h、12 h、24 h、48 h数字疼痛评分均比传统组低(P<0.05)。ERAS组术后1周营养风险筛查NRS2002评估表评分比传统组高(P<0.05)。结论ERAS策略可有效缩短高龄胃癌患者腹腔镜根治术后恢复时间,并可缓解疼痛,改善营养状况。

Objective To explore the application value of Enhanced Recovery after Surgery(ERAS)strategy in laparoscopic surgery of senile gastric cancer.Methods We retrospectively analyzed the cases data of 87 senile gastric cancer patients who underwent laparoscopic surgery from May 2017 to May 2020.According to whether the ERAS strategy was used in the perioperative period,87 patients were divided into ERAS group(42 cases)and traditional group(45 cases).Statistical analysis were performed by using SPSS 23.0 software.The perioperative indicators were conformed to be the normal distribution.The pain scoring,nutritional risk and other measurement data were expressed as (x±s),and were examined by using independent t test.The total incidence of complications were expressed as the rate,which were analyzed by usingχ^(2) test.A P value of<0.05 was considered as statistically significant difference.Results There were no significant difference of postoperative complications between two groups(P>0.05).The first eating time,exhausting time,first leaving bed time and hospitalization time of ERAS group were shorter than those in the traditional group respectively(P<0.05).NRS scores of ERAS group were lower than those in the traditional group at 6 h,12 h,24 h and 48 h after operation(P<0.05).The score of NRS2002 scale in ERAS group was higher than that in the traditional group at 1 week post operation(P<0.05).Conclusion ERAS strategy could effectively shorten the recovery time of senile patients with gastric cancer after laparoscopic radical gastrectomy,could relieve the pain and improve the nutritional status.