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中华普通外科学文献(电子版) ›› 2017, Vol. 11 ›› Issue (01) : 36 -40. doi: 10.3877/cma.j.issn.1674-0793.2017.01.009

所属专题: 文献

论著

加速康复外科在进展期胃癌围手术期的应用初探
邵俊1, 姜卫东1, 高淳1,(), 王志强1, 张云鹏1, 孙鹏1   
  1. 1. 200336 上海交通大学医学院附属同仁医院普外科
  • 收稿日期:2016-07-04 出版日期:2017-02-01
  • 通信作者: 高淳
  • 基金资助:
    上海市医学重点专科建设计划项目(ZK2015A25)

Investigation of enhanced recovery after surgery in perioperative period of advanced gastric cancer

Jun Shao1, Weidong Jiang1, Chun Gao1,(), Zhiqiang Wang1, Yunpeng Zhang1, Peng Sun1   

  1. 1. Department of General Surgery, Tongren Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200336, China
  • Received:2016-07-04 Published:2017-02-01
  • Corresponding author: Chun Gao
  • About author:
    Corresponding author: Gao Chun, Email:
引用本文:

邵俊, 姜卫东, 高淳, 王志强, 张云鹏, 孙鹏. 加速康复外科在进展期胃癌围手术期的应用初探[J/OL]. 中华普通外科学文献(电子版), 2017, 11(01): 36-40.

Jun Shao, Weidong Jiang, Chun Gao, Zhiqiang Wang, Yunpeng Zhang, Peng Sun. Investigation of enhanced recovery after surgery in perioperative period of advanced gastric cancer[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(01): 36-40.

目的

探讨进展期胃癌外科手术患者应用加速康复外科(ERAS)的可行性和安全性。

方法

选择2014年1月至2015年10月间行限期胃癌手术患者128例,分为传统组(60例)和ERAS组(68例)。分析比较两组患者的术中出血量、手术时间、术后住院时间、术后首次排气时间、平均进食时间、并发症、住院费用等指标。

结果

传统组与ERAS组患者术中出血量[(180±26.3)ml vs(175±30.0)ml]、手术时间[(145±23.3)min vs(151±26.1)min]比较差异无统计学意义;ERAS组在术后平均肠道排气时间、进食时间、离床活动时间、引流拔除时间、术后平均住院天数、住院费用等方面均较传统组时间少(P<0.01);两组术后并发症发生率差异无统计学意义。

结论

实施ERAS可以降低胃癌手术患者术后住院时间,减少住院费用,并不增加并发症的发生率,在上消化道胃癌手术中应用是安全可行的,但仍需进一步的大样本前瞻性临床试验支持。

Objective

To investigate the feasibility and safety of enhanced recovery after surgery (ERAS) in patients with advanced gastric cancer.

Methods

In this study, one hundred and twenty-eight patients with gastric cancer were enrolled between January 2014 and October 2015 and randomly divided into the traditional group (60 cases) and the ERAS group (68 cases). The amount of blood loss, operation time, postoperative hospital stay, the first exhaust time, average feeding time, complications and hospitalization expenses were analyzed and compared between the two groups.

Results

Bleeding volume in traditional group and ERAS group was (180±26.3) ml vs (175±30.0) ml, operation time was (145±23.3) min vs (151±26.1) min, respectively, with no statistically significant difference. In ERAS group, the average time of bowel exhaust, feeding, bed-off, drainage, length of stay and hospitalization expenses were less than those of the traditional group (P< 0.01). There was no significant difference in the incidence of postoperative complications between the two groups.

Conclusions

ERAS works positively in decreasing the hospitalization time and expenses for patients undergoing gastric operations, without raising postoperative complications. It is feasible and safe for ERAS’s application in upper gastrointestinal surgery, but still needs further large sample prospective clinical trials.

表1 两组进展期胃癌手术患者围手术期处理方法
表2 两组进展期胃癌患者一般情况比较
表3 两组进展期胃癌患者术中及术后情况比较(±s, t检验)
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