切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 415 -417. doi: 10.3877/cma.j.issn.1674-3946.2021.04.017

论著

加速康复外科策略在高龄胃癌腹腔镜术中的应用价值
周建萍1, 周晓梅1, 许容芳1,(), 曹汉忠1, 朱涛2   
  1. 1. 226019 南通大学附属肿瘤医院
    2. 610041 四川大学华西医院
  • 收稿日期:2020-06-29 出版日期:2021-08-17
  • 通信作者: 许容芳

Application value of enhanced recovery strategy after laparoscopic surgery for senile patients with gastric cancer

Jianping Zhou1, Xiaomei Zhou1, Rongfang Xu1,(), Hanzhong Cao1, Tao Zhu2   

  1. 1. Cancer Hospital Affiliated to Nantong University, Jiangsu 22601, China
    2. Huaxi Hospital, Sichuan University, Sichuan 610041, China
  • Received:2020-06-29 Published:2021-08-17
  • Corresponding author: Rongfang Xu
  • Supported by:
    Project of Sichuan Science and Technology Department(2018YFC2001800)
引用本文:

周建萍, 周晓梅, 许容芳, 曹汉忠, 朱涛. 加速康复外科策略在高龄胃癌腹腔镜术中的应用价值[J]. 中华普外科手术学杂志(电子版), 2021, 15(04): 415-417.

Jianping Zhou, Xiaomei Zhou, Rongfang Xu, Hanzhong Cao, Tao Zhu. Application value of enhanced recovery strategy after laparoscopic surgery for senile patients with gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(04): 415-417.

目的

探讨加速康复外科(ERAS)策略在高龄胃癌腹腔镜术中的应用价值。

方法

回顾性分析2017年5月至2020年5月接受腹腔镜胃癌根治术治疗的87例老年胃癌患者资料,根据围术期是否采用ERAS策略分为ERAS组(42例)和传统组(45例)。采用SPSS 23.0统计分析软件,围术期相关指标、疼痛程度、营养风险等计量资料以(±s)表示,独立t检验;并发症发生率比较采用χ2检验。P<0.05为差异有统计学意义。

结果

两组术后并发症总发生率相比,差异无统计学意义(P>0.05)。ERAS组首次进食时间、肛门排气时间、首次下床时间、住院时间均比传统组短(P<0.05)。ERAS组术后6 h、12 h、24 h、48 h数字疼痛评分均比传统组低(P<0.05)。ERAS组术后1周营养风险筛查NRS2002评估表评分比传统组高(P<0.05)。

结论

ERAS策略可有效缩短高龄胃癌患者腹腔镜根治术后恢复时间,并可缓解疼痛,改善营养状况。

Objective

To explore the application value of Enhanced Recovery after Surgery (ERAS) strategy in laparoscopic surgery of senile gastric cancer.

Methods

We retrospectively analyzed the cases data of 87 senile gastric cancer patients who underwent laparoscopic surgery from May 2017 to May 2020. According to whether the ERAS strategy was used in the perioperative period, 87 patients were divided into ERAS group (42 cases) and traditional group (45 cases). Statistical analysis were performed by using SPSS 23.0 software. The perioperative indicators were conformed to be the normal distribution. The pain scoring, nutritional risk and other measurement data were expressed as (±s), and were examined by using independent t test. The total incidence of complications were expressed as the rate, which were analyzed by using χ2 test. A P value of <0.05 was considered as statistically significant difference.

Results

There were no significant difference of postoperative complications between two groups (P>0.05). The first eating time, exhausting time, first leaving bed time and hospitalization time of ERAS group were shorter than those in the traditional group respectively (P<0.05). NRS scores of ERAS group were lower than those in the traditional group at 6 h, 12 h, 24 h and 48 h after operation (P<0.05). The score of NRS2002 scale in ERAS group was higher than that in the traditional group at 1 week post operation (P<0.05).

Conclusion

ERAS strategy could effectively shorten the recovery time of senile patients with gastric cancer after laparoscopic radical gastrectomy, could relieve the pain and improve the nutritional status.

表1 87例老年胃癌患者不同围术期策略两组基线资料比较[(±s),例]
表2 87例老年胃癌患者不同围术期策略两组围术期相关指标比较(±s)
表3 87例老年胃癌患者不同围术期策略两组术后NRS评分比较[(±s),分]
表4 87例老年胃癌患者不同围术期策略两组术前术后营养风险筛查NRS2002评估表评分比较[(±s),分]
表5 87例老年胃癌患者不同围术期策略两组术后并发症比较(例)
[1]
程康文,胡文君,王贵和,等. 加速康复外科理念在老年患者腹腔镜辅助胃癌根治术中的应用[J]. 中华老年多器官疾病杂志,2020,19(2):109-114.
[2]
阮小菱,彭程,刘红霞,等. 加速康复外科对腹腔镜胃癌根治术患者预后、负面情绪及心理应激的影响[J/CD]. 中国医学前沿杂志(电子版),2019,11(3):76-80.
[3]
Romario UF, Weindelmayer J, Coratti A, et al. Enhanced recovery after surgery in gastric cancer: which are the main achievements from the Italian experience?[J]. Updates Surg, 2018, 70(2): 257-264.
[4]
周建刚,邵荣,杨波. 加速康复外科对腹腔镜胃癌根治术病人应激及营养状况的影响[J]. 腹部外科,2018,31(5):354-357,361.
[5]
李欣龙,顾立虎,祝和攀,等. 加速康复外科理念在腹腔镜胃癌根治术中的应用[J]. 临床外科杂志,2019,27(5):408-411.
[6]
国家消化系统疾病临床医学研究中心,中华医学会消化内镜学分会,中华医学会健康管理学分会,等. 中国早期胃癌筛查流程专家共识意见(草案)[J]. 中华健康管理学杂志,2018,12(1):8-14.
[7]
Wang L-H, Zhu R-F, Cheng G, et al. Application of enhanced recovery after gastric cancer surgery: An updated meta-analysis[J]. World J Gastroenterol, 2018, 24(14): 1562-1578.
[8]
江华勇,蒋宗明,郑羡河,等. 加速康复外科策略对腹腔镜胃癌根治术老年患者术后早期认知功能和术后恢复的影响[J]. 中华全科医学,2018,16(9):1452-1454,1578.
[9]
罗德胜,徐宏涛,章平禄,等. 腹腔镜胃癌根治术患者实施加速康复外科的临床疗效分析[J]. 重庆医学,2019,48(18):3121-3125.
[10]
Li Z, Wang Q, Li B, et al. Influence of enhanced recovery after surgery programs on laparoscopy-assisted gastrectomy for gastric cancer: a systematic review and meta-analysis of randomized control trials[J]. World J Surg Oncol, 2017, 15(1): 207.
[11]
程康文,王贵和,束宽山,等. 加速康复外科在腹腔镜辅助胃癌根治术中的应用及其对患者术后恢复、营养及应激的影响[J]. 中国普通外科杂志,2019,28(10):1228-1236.
[12]
柏巍松,赵立志,唐纪全,等. 加速康复外科应用于全腹腔镜下远端胃癌D2根治术的价值及对炎症因子的影响[J]. 肿瘤研究与临床,2019,31(12):818-822.
[13]
韩超,解曙哲,连长红,等. 加速康复外科理念在全腹腔镜远端胃癌根治、胃十二指肠三角吻合术中的应用研究[J/CD]. 中华普外科手术学杂志(电子版), 2019,13(1):80-82.
[14]
Aratani K, Sakuramoto S, Chuman M, et al. Laparoscopy-assisted Distal Gastrectomy for Gastric Cancer in Elderly Patients: Surgical Outcomes and Prognosis[J]. Anticancer Research, 2018, 38(3): 1721-1725.
[15]
刘晓东,曹守根,周岩冰. 加速康复外科路径在全腹腔镜远端胃癌根治术围手术期中的应用[J]. 中华普通外科杂志,2020,35(2):152-153.
[1] 李凯, 陈淋, 向涵, 苏怀东, 张伟. 一种U型记忆合金线在经脐单孔腹腔镜阑尾切除术中的临床应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 15-15.
[2] 曹迪, 张玉茹. 经腹腔镜生物补片修补直肠癌根治术后盆底疝1例[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 115-116.
[3] 杜晓辉, 崔建新. 腹腔镜右半结肠癌D3根治术淋巴结清扫范围与策略[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 5-8.
[4] 周岩冰, 刘晓东. 腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 9-13.
[5] 张焱辉, 张蛟, 朱志贤. 留置肛管在中低位直肠癌新辅助放化疗后腹腔镜TME术中的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 25-28.
[6] 王春荣, 陈姜, 喻晨. 循Glisson蒂鞘外解剖、Laennec膜入路腹腔镜解剖性左半肝切除术临床应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 37-40.
[7] 李晓玉, 江庆, 汤海琴, 罗静枝. 围手术期综合管理对胆总管结石并急性胆管炎患者ERCP +LC术后心肌损伤的影响研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 57-60.
[8] 甄子铂, 刘金虎. 基于列线图模型探究静脉全身麻醉腹腔镜胆囊切除术患者术后肠道功能紊乱的影响因素[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 61-65.
[9] 逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[10] 莫波, 王佩, 王恒, 何志军, 梁俊, 郝志楠. 腹腔镜胃癌根治术与改良胃癌根治术治疗早期胃癌的疗效[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 644-647.
[11] 鲁鑫, 许佳怡, 刘洋, 杨琴, 鞠雯雯, 徐缨龙. 早期LC术与PTCD续贯LC术治疗急性胆囊炎对患者肝功能及预后的影响比较[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 648-650.
[12] 陈大敏, 曹晓刚, 曹能琦. 肥胖对胃癌患者手术治疗效果的影响研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 651-653.
[13] 孟飞龙, 华帅, 张莹, 路广海. 经脐单孔腹腔镜后鞘后入路在全腹膜外腹股沟疝修补术中的应用[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 658-660.
[14] 阿冲罗布, 陈颖, 谢德坤. 腹腔镜外囊完整剥离术治疗肝包虫病效果及对患者肝功能、预后的影响[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 666-669.
[15] 索郎多杰, 高红桥, 巴桑顿珠, 仁桑. 腹腔镜下不同术式治疗肝囊型包虫病的临床疗效分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 670-673.
阅读次数
全文


摘要