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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 20 -23. doi: 10.3877/cma.j.issn.1674-3946.2020.01.008

所属专题: 文献

论著

加速康复外科在肝门部胆管癌围手术期中的疗效分析
郭强1, 吐尔干艾力·阿吉1, 徐成1, 冉博1, 蒋铁民1, 张瑞青1, 邵英梅1,()   
  1. 1. 830054 新疆医科大学第一附属医院消化血管外科中心肝胆包虫外科
  • 收稿日期:2019-04-22 出版日期:2020-02-26
  • 通信作者: 邵英梅

Clinical observation of the application of enhanced recovery after surgery in treating hilarcholangiocarcinoma

Qiang Guo1, Aji Tuerganailio·1, Cheng Xu1, Bo Ran1, Tiemin Jiang1, Ruiqing Zhang1, Yingmei Shao1,()   

  1. 1. Department of Hepatobiliary & Hydatid Diseases, Digestive & Vascular Surgery Center, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang 830054, China
  • Received:2019-04-22 Published:2020-02-26
  • Corresponding author: Yingmei Shao
  • About author:
    Corresponding author: Shao Yingmei, Email:
  • Supported by:
    Key discipline of the 13th five-year plan of autonomous region (Peak discipline)(New Teaching Research (2016) No.7); Natural Science Foundation of Xinjiang Uygur Autonomous Region(No.2018D01C220); National Natural Science Foundation of China(No.81660108); National Key R&D Program of China(No.2017YFC0909903); Provincial and ministerial Co-construction of the National Key laboratory for the Cause and prevention of high morbidity in Central Asia(No.SKL-HIDCA-2017-1)
引用本文:

郭强, 吐尔干艾力·阿吉, 徐成, 冉博, 蒋铁民, 张瑞青, 邵英梅. 加速康复外科在肝门部胆管癌围手术期中的疗效分析[J/OL]. 中华普外科手术学杂志(电子版), 2020, 14(01): 20-23.

Qiang Guo, Aji Tuerganailio·, Cheng Xu, Bo Ran, Tiemin Jiang, Ruiqing Zhang, Yingmei Shao. Clinical observation of the application of enhanced recovery after surgery in treating hilarcholangiocarcinoma[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(01): 20-23.

目的

探讨加速康复外科理念(ERAS)在肝门部胆管癌(HCCA)围手术期中的可行性与安全性。

方法

回顾性分析2015年1月至2018年1月48例HCCA患者,其中25例患者围手术期行加速康复外科处理(ERAS组),23例患者围手术期进行传统处理(传统组),采用SPSS 19.0软件进行统计分析。术中术后各项指标、术后疼痛评分、患者满意度采用(±s)表示,独立t检验;术后并发症等使用χ2检验,P<0.05为差异有统计学意义。

结果

两组术前生化指标TBiL、ALT、AST、ALB无差异,术后第7天ERAS组TBiL、ALT、AST显著低于传统组,而ALB显著高于传统组(P<0.05); ERAS组术后首次排气时间、术后平均住院时间、医疗费用均显著减少(P<0.05)。ERAS组术后并发症2例(8%)低于传统组9例(39.1%),差异有统计学意义(P<0.05)。

结论

在HCCA围手术期中实施ERAS模式是可行的、安全有效的,有助于加快患者术后康复、有利于改善患者预后。

Objective

To investigate the feasibility and safety of the application of Enhanced Recovery After Surgery (ERAS) in the perioperative treatment of hilar cholangiocarcinoma (HCCA).

Methods

A retrospective study was conducted in 48 patients with HCCA and underwent surgical treatment from January 2015 to January 2018. Among them, there were 25 cases underwent ERAS perioperative management (ERAS group), while 23 cases underwent traditionally perioperative management (traditional group). Statistical analysis were performed by using spss 19.0 software. Measurement data, such as intraoperative and postoperative indicators, postoperative pain scores and patient satisfaction were expressed as (±s), and were examined by using independent t test. Count data such as complication rates were examined by chi square test. A P value <0.05 was considered as statistically significant difference.

Results

There was no significant difference in terms of TBIL, ALT, AST and ALB between two groups before operation. However on the 7th day after operation, the TBIL, ALT, AST were significantly lower and ALB was significantly higher in ERAS group than those in traditional group respectively (P<0.05). The first anal exsufflation time, postoperative hospital stay, and medical costs were significantly lower in ERAS group than those in traditional group respectively (P<0.05). There were 2 cases(8%) of postoperative complications occurred in ERAS group, which were significantly lower than 9 cases (39.1%) in traditional group.

Conclusions

It is feasible, safe and effective that perioperative ERAS management in treating HCCA, which is helpful to accelerate the postoperative recovery and could improve the prognosis of patients.

表1 48例HCCA患者不同围术期治疗措施术前两组一般资料比较[(±s),例]
表2 48例HCCA患者不同围术期处理方法两组术中指标比较[(±s),例]
表3 48例HCCA患者不同围术期处理方法两组术后临床指标比较(±s)
表4 48例HCCA患者不同围术期处理方法两组术后第7天生化指标比较(±s)
表5 48例HCCA患者不同围术期处理方法两组术后并发症比较[例(%)]
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