快速康复外科理念在食管癌、贲门癌手术中的应用

Fast track surgery concept application in surgery of esophageal and cardiac carcinoma

目的探讨快速康复外科(fast track surgery,FTS)理念在食管癌、贲门癌手术中应用的可行性和有效性。方法选取我院2011年1月至2013年12月食管癌、贲门癌手术患者80例。采用随机数字表法将患者随机分为对照组和FTS组,每组40例。FTS组按照FTS方案治疗,对照组按照传统方法治疗。比较两组术后疼痛评分、胃肠功能恢复时间、术后住院时间、住院费用及术后并发症等。结果 FTS组患者术后早期6、24、48小时疼痛视觉模拟评分法(visual analogue scales,VAS)评分(4.5±0.3,4.2±0.2,3.2±0.1)均明显低于对照组(6.5±0.1,6.1±0.3,4.8±0.2),差异有统计学意义(P﹤0.05);FTS组患者肠鸣音恢复时间、肛门排气时间、住院时间和住院费用均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率[7.5%(3/40例)与15.0%(6/40例)]比较,差异无统计学意义(字2=1.1268,P=0.2885)。结论 FTS措施的应用在食管癌、贲门癌手术中是安全的,可有效减轻患者术后疼痛,缩短住院时间,加速患者术后康复,节省医疗费用,必将成为外科发展的趋势。

Objective To explore the feasibility and availability of fast track surgery (FTS) concept used in surgery of esophageal and cardiac carcinoma. Methods Eighty patients with esophageal and cardiac cancer in our hospital from January 2011 to December 2013 were selected. According to random number table method, patients were randomly divided into control group and FTS group, forty cases in each. FTS group followed the FTS treatment solution while control group followed the traditional method of treatment. Postope-rative pain score, gastrointestinal function recovery time and hospital stay, postoperative hospitalization ex-penses and the postoperative complications were compared between the two groups. Results Patients in FTS group with early postoperative 6, 24, 48 h method of visual analog score (VAS) (4.5±0.3, 4.2±0.2, 3.2±0.1) were significantly lower than the control group (6.5±0.1, 6.1±0.3, 4.8±0.2), the difference was significant sta-tistically (P<0.05) . FTS group of patients with bowel sound recovery time, length of hospital stay, anal exhaust time and hospitalization costs were lower than the control group, the difference was significant statistically (P<0.05) . There was no statistically significant difference (χ2=1.1268, P=0.2885) between the two groups of com-plications which was 7.5% (3/40 cases) and 7.5% (6/40 cases). Conclusion FTS measures applied in the esophageal and cardiac cancer surgery is safe. Patients can effectively reduce postoperative pain and shortenhospital stay. FTS can not only accelerate the patients’postoperative rehabilitation, but also save medical ex-pense. FTS will become the trend of the development of the surgery.