快速康复外科对胰头癌前入路原位胰十二指肠切除术患者早期预后的影响分析

Effect of enhanced recovery after surgery on early prognosis of patients undergoing panereatoduodenectomy with precancerous approach of pancreatic head

目的分析快速康复外科(ERAS)对胰头癌前入路原位胰十二指肠切除术患者早期预后的影响。方法选取2018年7月至2020年7月收治的98例胰头癌患者,采用随机数字表法将患者随机分为ERAS组和常规组,每组各49例,均行前入路原位胰十二指肠切除术,常规组接受围手术期常规康复干预,ERAS组接受基于ERAS理念的围手术期干预。使用SPSS 22.0统计学软件分析数据,术中术后各项计量资料以(x±s)表示,行独立样本t检验;术后并发症发生率、二次手术率、1年随访结果采用χ^(2)检验。P<0.05为差异有统计学意义。结果ERAS组患者术后住院时间、肛门排气时间引流管拔除时间均低于常规组(P<0.05)。ERAS组患者术后并发症发生率为14.3%,低于常规组的42.9%(P<0.05)。ERAS组二次手术率为22.4%,低于常规组的42.9%(P<0.05)。术后1年,ERAS组与常规组患者局部复发率、远处转移率、死亡率比较,差异无统计学意义(P>0.05)。结论ERAS能够促进胰头癌前入路原位胰十二指肠切除患者术后早期恢复,降低并发症发生率、二次手术率。

Objective To analyze the effect of enhanced recovery after surgery(ERAS)on the early prognosis of patients undergoing panereatoduodenectomy with precancerous approach of pancreatic head.Methods 98 patients with pancreatic head cancer treated from July 2018 to July 2020 were randomly divided into ERAS group and routine group.with 49 cases in each group undergoing anterior approach orthotopic pancreaticoduodenccomy.Routine group received routine rchabilitation intenenion during perioperative period,while ERAS group received perioperative intervention based on ERAS concept.SPSS 22.0 statistical software was used to analyze the data.Intraoperative and postoperative measurement data were expressed as(x±s).Independent sample t test was performed;The ineidence of postoperative complications,the rate of second operation and the results of 1-year follow-up were tested by χ^(2) test.P<0.05 was considered statistically sigmifcant.Results The postoperative hospital stay,anal exhaust time and drainage tube removal time of the fast rehabilitation group were lower than those of the conventional group(P<0.05).The incidence of postoperative complications in the ERAS gruop was 14.3%,which was lower than 42.9%in the conventional group(P<0.05).The second operation rate of fast rehabilitation group was 22.4%,which was lower than 42.9%of conventional group(P<0.05).One year after operation,there was no signifcant difference in local recurrence nate,distant metastasis rate and mortality rate between ERAS gruop and conventional group(P>0.05).Conclusion ERAS can promole early recovery after pancreatoduodenectomy via anterior apprach,and reduce the ineidence of complications and reoperation rate.