高龄右半结肠癌切除应用快速康复外科疗效分析

doi:10.3969/j.issn.1005-6483.2020.05.012

摘要/Abstract

摘要： 目的:评价快速康复外科（ERAS）应用于高龄右半结肠癌切除病人的安全性和疗效分析。方法:2016年3月～2019年12月收治的右半结肠癌病人65例，随机分为ERAS组和对照组，ERAS组35例，采用快速康复外科诊疗模式，对照组30例，采用传统诊疗模式。比较两组手术时间、术中出血量、术后排气时间、排便时间、术后住院时间、术后炎症因子水平、术后并发症和病人满意度。结果:65例病人均顺利康复出院，ERAS组和对照组术后排气时间（46.8±3.2）小时和（58.4±2.1）小时，排便时间分别为（66.5±4.2）小时和（78.3±3.5）小时，术后住院时间分别为5.2天和8.6天，术后第1、3天炎症因子降钙素原水平PCT分别为（1.3±0.2）ng/ml、（3.2±0.6）ng/ml；（0.63±0.14）ng/ml、（1.5±0.2）ng/ml），C反应蛋白水平CRP分别为（128.5±3.5）ng/ml、（150.7±7.2）ng/ml，（88.2±4.2）ng/ml、（109.4±6.5）ng/ml，术后肺部感染率分别为2.86%和13.33%，病人满意度分别为98.6分和93.2分，两组比较差异有统计学意义（P<0.05）。两组手术时间和出血量比较差异无统计学意义（P>0.05），两组术后腹胀、呕吐和肠梗阻比较差异无统计学意义（P>0.05）。结论:在高龄右半结肠癌切除病人中，应用ERAS可促进胃肠功能早期恢复，缩短住院时间，降低机体炎症反应水平，减少术后肺部感染的发生，提高满意度。

关键词: 加速康复外科, 高龄, 右半结肠癌切除

Abstract: Objective:To investigate the safety and clinical effect of enhanced recovery after surgery（ERAS）in right hemicolectomy for elderly patiens with colon cancer.Methods:65 patients diagnosed with right colon cancer were selected between March 2016 to December 2019 in Guang dong nongken central hospital.According to the digestive tract reconstruction method，the patients were divided into 35 cases in the ERAS group and 30 cases in the control group.ERAS group received enhanced recovery after surgery management，while contral group received traditional managnement.operation time，blood loss，postoperative exhaust and defecation time，postoperative hospital stay，postoperative inflammatory factor level，postoperative complications and patient satisfaction of the two groups was compared.Results:All the 65 patients recovered and were discharged smoothly，and the postoperative exhaust time of ERAS group and control group were（46.8±3.2）h vs（58.4±2.1）h and defecating time were（66.5±4.2）h vs（8.3±3.5）h，respectively.Postoperative hospitalization days were（5.2d vs 8.6d，respectively.The ERAS group were shorter than those in the control group（P<0.05）.The levels of inflammatory factors in postoperative day 1 and day 3，PCT were（1.3±0.2）ng/ml and（3.2±0.6）ng/ml，（0.63±0.14）ng/ml and（1.5±0.2）ng/ml），respectively.CRP were（128.5±3.5）ng/ml and（150.7±7.2）ng/ml，（88.2±4.2）ng/ml and（109.4±6.5）ng/ml，respectively.The postoperative pulmonary infection were 2.86% vs 13.33%，，respectively.Which were lower than the control group（P<0.05）.The satisfaction of patients were 98.6 vs 93.2，respectively.Which was higher than that of the control group（P>0.05），and there was no significant difference in operation time and blood loss between the two groups（P>0.05）.There was no significant difference in postoperative abdominal distension，vomiting and intestinal obstruction between the two groups（P>0.05）.Conclusion:In the elderly patients with right hemicolectomy for colon cancer ，the application of ERAS can promote the early recovery of gastrointestinal function，shorten the length of hospital stay，reduce the level of inflammatory response，reduce the incidence of post〖LM〗operative pulmonary infection，improve patient satisfaction，and improve medical experience，which is safe and effective.

Key words: enhanced recovery after surgery, elderly patients, right hemicolectomy

黄永亨, 吴国忠, 庞绍春等. 高龄右半结肠癌切除应用快速康复外科疗效分析[J]. 临床外科杂志, 2020, 28(5): 444-446.

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