胃肠肿瘤患者围手术期快速康复外科模式对术后恢复的影响

丁燕,王蓓,李久凡,常娟娟

肿瘤代谢与营养电子杂志 ›› 2017, Vol. 4 ›› Issue (3) : 312.

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肿瘤代谢与营养电子杂志 ›› 2017, Vol. 4 ›› Issue (3) : 312.
论著

胃肠肿瘤患者围手术期快速康复外科模式对术后恢复的影响

  • 丁燕,王蓓,李久凡,常娟娟
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The postoperative recovery of fast track surgery pattern in gastrointestinal cancer patients#br#

  • DING Yan, WANG Bei, LI Jiu-fan, CHANG Juan-juan
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摘要

目的 探讨快速康复外科模式应用于胃肠肿瘤患者围手术期对促进患者术后康复的安全性及有效性。方法  将 260 例胃肠肿瘤手术患者随机分成两组,使用快速康复外科模式治疗132例(FTS组),使用传统方法治疗128例(TPM 组)。分析研究两组患者术前、术后焦虑,抑郁分值;术中体温、术后低体温及寒战发生率;术后镇痛效果;手术患者满 意度及手术并发症、ICU 住院时间、费用和住院天数等指标并分别进行对比分析。结果  术前及术后FTS 组患者的焦虑、 抑郁评分和HAD 总分显著低于TPM 组;FTS 组与TPM 组术中体温变化无明显差别,FTS 组术后低体温和术后寒战发生 率明显低于TPM 组;FTS 组术后镇痛效果优于TPM 组;FTS 组患者手术的满意度显著高于TPM 组患者,手术切口感染 发生率低于 TPM 组患者,FTS 组患者 ICU 住院时间、肺部感染发生率、医疗费用和住院天数均低于 TPM 组,但腹部并发 症两组无明显差异。结论  胃肠肿瘤患者围手术期采用快速康复外科模式可明显降低患者手术并发症发生率、缩短 ICU 和 总体住院时间、节省医疗费用并提高手术患者满意度。

Abstract

Objective To study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastrointestinal cancer patients during the perioperative period. Methods 260 gastrointestinal cancer patients were randomly divided into two groups, 132 in FTS pattern (FTS group) and 128 in traditional pattern mode (TPM group). Analysis and research on the scores of hospital anxiety and depression scale (HAD) before and after operation, intraoperative temperatures, the incidence of postoperative hypothermia and chills, postoperative pain, patients' satisfaction and wound healing were compared. Results The score of anxiety, depression and HAD, incidence of postoperative hypothermia and chills, postoperative incision infection rate were lower in FTS group. FTS also provided superior pain relief and patients' satisfaction compared with traditional pattern. There was no significantly different between the two groups for the intraoperative temperatures. FTS group of patients with ICU hospitalization time, incidence of pulmonary infection, medical expenses and hospitalization time were lower than those of TPM group, but the complications about the abdomen had no difference between the two groups. Conclusions Perioperative gastrointestinal cancer patients with fast track surgery mode could be significantly reduced the incidence of surgical complications in patients, shorten the hospitalization time and total ICU, saved medical costs and improved the patients' satisfaction.

关键词

快速康复外科模式 / 胃肠肿瘤 / 围手术期

Key words

Fast track surgery pattern / Gastrointestinal cancer / Perioperative period

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丁燕,王蓓,李久凡,常娟娟. 胃肠肿瘤患者围手术期快速康复外科模式对术后恢复的影响[J]. 肿瘤代谢与营养电子杂志. 2017, 4(3): 312
DING Yan, WANG Bei, LI Jiu-fan, CHANG Juan-juan. The postoperative recovery of fast track surgery pattern in gastrointestinal cancer patients#br#[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2017, 4(3): 312

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