加速康复外科干预对腹腔镜进展期结直肠癌患者术后疗效的影响

Effect of accelerated rehabilitation surgical intervention on postoperative outcomes in patients with laparoscopic advanced colorectal cancer

目的探讨加速康复外科干预对腹腔镜进展期结直肠癌患者术后疗效的影响。方法选取2017年10月至2020年1月安徽省阜阳市人民医院85例进展期结直肠癌患者,依据随机数字表法分为试验组(43例)和对照组(42例)。试验组行腹腔镜进展期结直肠癌根治术+加速康复外科干预,对照组行腹腔镜进展期结直肠癌根治术+常规干预。比较两组首次排气、下床活动、排便及术后住院时间;比较两组术前及术后7 d的血红蛋白(Hb)、白蛋白(ALB)水平;比较两组术后6、48 h的疼痛程度;采用EORTC QLQ-C30测评表对两组术前及术后1个月的生存质量进行评分;记录两组并发症的发生情况及满意度。结果试验组术后首次排气时间、下床活动时间、排便时间及术后住院时间短于对照组(P<0.05)。术前,两组ALB、Hb水平比较,差异无统计学意义(P>0.05);术后7 d,试验组ALB、Hb水平高于对照组(P<0.05)。试验组术后6、48 h视觉模拟评分法评分低于对照组(P<0.05)。术前,两组EORTC QLQ-C30评分比较,差异无统计学意义(P>0.05);术后1个月,试验组躯体、情感、角色、认知及社会功能评分高于对照组(P<0.05)。试验组术后并发症总发生率低于对照组(P<0.05)。两组术后满意度比较,差异无统计学意义(P>0.05)。结论在腹腔镜进展期结直肠癌根治术中应用加速康复外科干预能有效缩短排气、住院时间等,降低患者的术后疼痛和并发症发生率,提高生活质量和满意度。

Objective To investigate the effect of accelerated rehabilitation surgical intervention on postoperative outcomes in patients with laparoscopic advanced colorectal cancer.Methods A total of 85 patients with advanced colorectal cancer in Fuyang People’s Hospital of Anhui Province from October 2017 to January 2020 were selected,and they were divided into the experimental group(43 cases)and the control group(42 cases)according to random number table method.The experimental group received laparoscopic advanced colorectal cancer radical resection+accelerated rehabilitation surgical intervention,while the control group received laparoscopic advanced colorectal cancer radical resection+routine intervention.The first exhaust,getting out of bed,defecation and postoperative hospital stay were compared between the two groups;the levels of hemoglobin(Hb)and albumin(ALB)before surgery and seven days after surgery were compared between the two groups;the pain level of the two groups were compared 6 and 48 h after operation;EORTC QLQ-C30 was used to score the quality of life before surgery and one month after surgery;and the occurrence of complications and satisfaction were recorded in the two groups.Results The first exhaust time,getting out of bed time,defecation time and postoperative hospital stay in the experimental group were shorter than those in the control group(P<0.05).Before surgery,there were no significant differences in the levels of ALB and Hb between the two groups(P>0.05).Seven days after surgery,the levels of ALB and Hb in the experimental group were higher than those in the control group(P<0.05).The visual analogue scale score of the experimental group was lower than that of control group 6 and 48 h after surgery(P<0.05).Before surgery,there was no significant difference in EORTC QLQ-C30 score between the two groups(P>0.05),one month after surgery,the scores of physical,emotional,role,cognitive and social function in the experimental group were higher than those in the control group(P<0.05).The total incidence of postoperative complications in the experimental group was lower than that in the control group(P<0.05).There was no significant difference in postoperative satisfaction between the two groups(P>0.05).Conclusion The application of accelerated rehabilitation surgical intervention in laparoscopic advanced colorectal cancer resection can shorten exhaust time and hospital stay,reduce the postoperative pain and complications rate,and improve quality of life and satisfaction.