基于ERAS理念的优化术前预康复对食管癌患者围术期功能状态及预后影响

Effects of preoperative pre-rehabilitation optimization based on ERAS on perioperative functional status and prognosis of patients with esophageal cancer

目的:探讨基于加速康复外科(ERAS)理念优化的术前预康复策略对食管癌患者围术期功能状态、手术预后的影响效果。方法:选取2016年2月至2021年9月本院胸外科79例食管癌根治术患者为研究对象,对照组42例实施ERAS围术期护理方案,观察组37例在此基础上优化术前预康复策略。分别计算入院-术前1d、入院-术后14d两个时间段的营养状态(体质量减少、体质指数、前白蛋白、白蛋白),统计排气时间、胸腔引流管拔除时间、住院时间、并发症总发生率,比较以上观察指标数值差异。结果:观察组入院-术前1d以及入院-术后14d的体质量减少、入院-术后14d的体质指数、前白蛋白、白蛋白、排气时间、胸腔引流管拔除时间、住院时间、并发症总发生率均优于对照组(P<0.05)。结论:基于ERAS理念优化的术前预康复策略的应用,有助于改善食管癌患者围术期功能状态及手术预后,具有较大的使用价值。

Objective:To investigate the effects of preoperative pre-rehabilitation strategies optimized based on the concept of Accelerated Rehabilitation surgery(ERAS)on perioperative functional status and operative prognosis of patients with esophageal cancer.Methods:79 patients with radical esophagectomy of esophageal cancer in thoracic surgery department of our hospital from February 2016 to September 2021 were selected as the study objects,42 patients in control group received ERAS perioperative nursing program,and 37 patients in observation group were optimized preoperative pre-rehabilitation strategy on this basis.The nutritional status(weight loss,body mass index,prealbumin and albumin)in two periods from admission to 1 day before surgery and 14 days after admission to 14 days after surgery were calculated,respectively.The exhaust time,the time of thoracic drainage tube removal,the length of hospital stay and the total incidence of complications were calculated,and the numerical differences of the above observation indexes were compared.Results:The weight loss,body mass index,prealbumin,albumin,exhaust time,thoracic drainage tube removal time,length of hospital stay and total incidence of complications in the observation group were all better than those in the control group(P<0.05).Conclusion:The application of preoperative pre-rehabilitation strategy optimized based on ERAS concept is helpful to improve perioperative functional status and operative prognosis of patients with esophageal cancer,and has great value for application.