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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 195 -198. doi: 10.3877/cma.j.issn.1674-3946.2021.02.021

所属专题: 文献

论著

ERAS下腹腔镜辅助右半结肠癌扩大根治术的临床研究
徐国志1,(), 彭艺1, 陈龙1, 罗生1, 黄浪潮1   
  1. 1. 525300 广东省信宜市人民医院 肝胆胃肠外科
  • 收稿日期:2020-06-16 出版日期:2021-04-26
  • 通信作者: 徐国志

Clinical study of ERAS laparoscopic assisted enlarged radical resection of right colon carcinoma

Guozhi Xu1,(), Yi Peng1, Long Chen1, Sheng Luo1, Langchao Huang1   

  1. 1. Department of Hepatobiliary and Gastrointestinal Surgery, Xinyi People's Hospital, Guangdong 525300
  • Received:2020-06-16 Published:2021-04-26
  • Corresponding author: Guozhi Xu
  • Supported by:
    Guangdong Medical Research Fund Project(A2018090)
引用本文:

徐国志, 彭艺, 陈龙, 罗生, 黄浪潮. ERAS下腹腔镜辅助右半结肠癌扩大根治术的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(02): 195-198.

Guozhi Xu, Yi Peng, Long Chen, Sheng Luo, Langchao Huang. Clinical study of ERAS laparoscopic assisted enlarged radical resection of right colon carcinoma[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(02): 195-198.

目的

探讨加速康复外科(ERAS)应用于腹腔镜右半结肠癌扩大根治术患者的临床疗效。

方法

选取2017年1月至2019年12月行腹腔镜辅助右半结肠癌扩大根治术的进展期右半结肠癌患者50例,随机数字法将患者分为ERAS组和传统组,各25例。在围术期分别给予ERAS和传统处理措施,使用统计学软件SPSS 24.0进行临床数据分析,围术期指标等计量资料采用(±s)表示,组间采用独立t检验;术后并发症等计数资料采用χ2检验;以P<0.05为检验标准。

结果

ERAS组术后首次排气时间、首次排便时间、下床活动时间及住院时间均较传统组更短;ERAS组并发症总发生率低于传统组,分别为12.0%及36.0%,以上两组间差异均有统计学意义(P<0.05)。两组患者术前1 d的白细胞、Cor、CRP及IL-6指标比较无明显差异(P>0.05),术后3 d ERAS组患者上述4项指标均明显小于传统组(P<0.05)。两组患者入院时血清白蛋白及前白蛋白水平比较差异无统计学意义(P>0.05)。术前1 d及术后3 d,ERAS组患者血清白蛋白及前白蛋白水平均明显高于对照组患者(P<0.05)。

结论

围术期应用ERAS理念于腹腔镜辅助右半结肠癌扩大根治术患者安全可行且有效,可减少患者应激反应,降低术后并发症发生率,加速患者术后早期康复。

Objective

To observe the clinical effect of accelerated rehabilitation surgery (ERAS) laparoscopic enlarged radical resection of right colon cancer.

Methods

From January 2017 to December 2019, a total of 50 patients with advanced right colon cancer who underwent laparoscopic assisted enlarged radical resection of right colon cancer were randomly divided into ERAS group and traditional group, with 25 patients in each group . The patients were given ERAS measures and traditional treatment measures respectively during the perioperative period. SPSS 24.0 was used for clinical data analysis, Measurement data such as perioperative indicators were represented by (±s), the results were compared with t test, the statistical data of postoperative complications were tested by χ2 test. P<0.05 was considered statistically significant.

Result

The first postoperative exhaust time, first defecation time, time of getting out-of-bed time and hospitalization time in ERAS group were shorter than those in the traditional group (12% and 36.0%, respectively), and the difference above between the two groups were statistically significant (P<0.05). There were no significant difference in WBC, COR, CRP and IL-6 between the two groups one day before surgery (P>0.05), and the above 4 indexes in ERAS group were significantly lower than those in the traditional group (P<0.05). There was no significant difference in serum albumin and prealbumin levels between the two groups at admission (P>0.05). The levels of serum albumin and prealbumin in ERAS group were significantly higher than those in control group 1 day before operation and 3 days after operation (P<0.05).

Conclusion

ERAS is safety、feasible and effective in perioperative period for patients undergoing laparoscopic-assisted radical resection of right colon cancer, which can reduce the stress response of patients, reduce the incidence of postoperative complications and accelerate the early postoperative recovery of patients.

表1 50例右半结肠癌扩大根治术患者不同围手术期处理两组患者一般临床资料比较[(±s),例]
图2 腹腔镜根治性右半结肠切除术(解剖肠系膜上静脉外科干)
图3 腹腔镜根治性右半结肠切除术(解剖显露结肠中动脉)
图4 腹腔镜根治性右半结肠切除术(右半结肠血管解剖)
表2 50例右半结肠癌扩大根治术患者不同围术期处理两组术后各项指标比较(±s)
表3 50例右半结肠癌扩大根治术患者不同围术期处理两组患者并发症发生情况比较(例)
表4 50例右半结肠癌扩大根治术患者不同围术期处理两组术后应激反应指标比较(±s)
表5 50例右半结肠癌扩大根治术患者不同围术期处理两组患者术后营养状况比较(±s)
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