关键词: 快速康复外科, 早期胃癌, 腹腔镜, 胃切除术, 营养状态, 预后

Abstract: [Abstract] Objective To explore the effect of rapid rehabilitation surgery on the nutritional status of patients undergoing laparoscopic-assisted pyloric sparing gastrectomy for early gastric cancer. Methods A retrospective selection of 80 patients with early gastric cancer who were diagnosed in our hospital from March 2014 to August 2018 and combined with early gastric cancer laparoscopic-assisted pyloric sparing gastrectomy were used as research data.According to whether or not rapid rehabilitation surgery was performed,they were divided into control group(48 cases) and observation group(32 cases),among them,the traditional surgical diagnosis and treatment plan for the control group,the rapid rehabilitation surgical treatment plan for the observation group,and observe and record the postoperative recovery of the two groups of patients(hospitalization time,first exhaust time,gastric tube removal time,and liquid diet recovery time And defecation time),postoperative nutritional status(ALB,PAB,HB level),and follow-up status(quality of life,complication rate,and survival rate). Results Postoperative hospitalization time,first exhaust time,gastric tube removal time,restoring liquid diet time,and defecation time in the observation group were shorter than those in the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in the scorespreoperative PG-SGA in the two groups (P>0.05).The PG-SGA scores of the two groups of patients decreased after 14 days,but the PG-SGA scores of patients in the observation group decreased more significantly,and the difference was statistically significant(P＜0.05).After 30 days,the PG-SGA score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in the levels of ALB,PAB,and HB between the two groups before surgery(P>0.05).The level of ALB,PAB,and HB were significantly reduced in the two groups at 7 days after surgery,but the level of PAB decreased more significantly in the control group,and the difference was statistically significant(P＜0.05).The level of ALB,PAB,and HB in the two groups were significantly lower on day 14 after surgery than on day 7 after surgery.The levels of ALB,PAB,and HB in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P＜0.05);The postoperative follow-up found that the incidence of complications of grade Ⅰ,grade Ⅱ,grade Ⅲ,grade Ⅳ,and grade Ⅴ in the observation group were 15.63%,40.63%,6.25%,3.13%,and 3.13%,respectively,which were significantly lower than those in the control group(16.67%,50.00%,8.33%,6.25%,4.17%,respectively),the difference was statistically significant(P＜0.05). Conclusion Rapid rehabilitation surgery can speed up the recovery of patients after surgery,reduce the length of hospitalization,and restore the nutritional level of patients faster after surgery,which is conducive to the prognosis of the disease and reduces complications.

Key words: rapid rehabilitation surgery, early gastric cancer, laparoscopy, gastrectomy, nutritional status, prognosis