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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 291 -294. doi: 10.3877/cma.j.issn.1674-3946.2022.03.016

论著

快速康复外科理念用于进展期胃癌D2根治术围术期的临床价值
李璐1,(), 郝一鸣1, 于沛华1   
  1. 1. 710032 西安,空军军医大学第一附属医院消化外科
  • 收稿日期:2021-01-28 出版日期:2022-04-26
  • 通信作者: 李璐

Perioperative clinical value of rapid rehabilitation surgery for D2 radical resection of advanced gastric cancer

Lu Li1,(), Yiming Hao1, Peihua Yu1   

  1. 1. Department of Digestive Surgery,The First Affiliated Hospital of Air Force Military Medical University,Xi’an Shanxi Province 710032,China
  • Received:2021-01-28 Published:2022-04-26
  • Corresponding author: Lu Li
  • Supported by:
    China Health Promotion Foundation-Li Jieshou Intestinal Barrier Research Project(LJS-201704)
引用本文:

李璐, 郝一鸣, 于沛华. 快速康复外科理念用于进展期胃癌D2根治术围术期的临床价值[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(03): 291-294.

Lu Li, Yiming Hao, Peihua Yu. Perioperative clinical value of rapid rehabilitation surgery for D2 radical resection of advanced gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(03): 291-294.

目的

探究快速康复外科(ERAS)理念用于进展期胃癌D2根治术围手术期的临床价值。

方法

回顾性分析2018年5月至2020年5月我院收治的637例进展期胃癌患者病例资料,根据围手术期不同处理方式分为ERAS组(n=327例)和传统组(n=310例)。统计分析软件采用SPSS 22.0,术中和术后相关指标和应激指标以(

xˉ
±s)表示,采用独立样本t检验;并发症等计数资料采用χ2检验。P<0.05为差异有统计学意义。

结果

ERAS组患者术后输液量、住院天数、首次通气时间、首次进食时间、胃管留置时间和引流管拔除时间均小于传统组(P<0.05);术后1 d和3 d,ERAS组患者血清C反应蛋白和白细胞水平少于传统组(P<0.05)。ERAS组患者术后并发症总发生率和术后1年复发率较传统组低(30.6% VS. 48.4%,6.4% VS. 20.9%),差异均有统计学意义(P<0.05)。

结论

ERAS理念用于进展期胃癌D2根治术可减少患者术后首次排气排便时间、拔除引流管时间、进食时间等,有助于减轻机体炎症反应,降低术后并发症发生率。

Objective

To investigate the perioperative value of of enhanced recovery after surgery(ERAS)in D2 radical gastrectomy for advanced gastric cancer.

Methods

A retrospective analysis was performed on the clinical data of 637 patients with gastric cancer from May 2018 to May 2020. According to different methods of perioperative management,they were divided into ERAS group(n=327 cases)and traditional group(n=310 cases). SPSS 22.0 was used for statistical analysis. The intraoperative and postoperative related indexes and stress indexes were tested by(

xˉ
±s)and independent t test. χ2 test was used for complications. P<0.05 was considered statistically significant.

Results

In ERAS group,postoperative fluid infusion,length of hospital stay,time of first ventilation,time of first feeding,time of gastric tube indwelling and time of drainage tube removal were all shorter than those in traditional group(P<0.05). The levels of C-reactive protein and white blood cells in the ERAS group were lower than those in the traditional group 1 and 3 days after operation,and the differences were statistically significant(P<0.05). The total incidence of postoperative complications and 1 year recurrence rate in ERAS group were lower than those in traditional group(30.6% VS. 48.4%,6.4% VS. 20.9%),with statistical significance(P<0.05).

Conclusion

The application of ERAS in D2 radical gastrectomy for advanced gastric cancer can reduce the time of initial postoperative defecation,drainage tube removal,feeding,etc.,which can help reduce the inflammatory response of the body and reduce the incidence of postoperative complications.

表1 637例进展期胃癌不同围手术期管理方式两组患者基础性资料比较(例)
表2 637例进展期胃癌不同围手术期管理方式两组患者术后相关指标比较(
xˉ
±s)
表3 637例进展期胃癌不同围手术期管理方式两组患者术后并发症发生率和术后1年复发率比较[例(%)]
表4 637例进展期胃癌不同围手术期管理方式两组患者术后应激指标的比较(
xˉ
±s)
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