作者：陈声飞，阙剑锋，黄嘉俊，刘跃强，倪新建，丁志平，邓守庭，胡斌

单位：广东博罗县人民医院 普通外科，广东 博罗 516100

Authors:  CHEN Shengfei, QUE Jianfeng, HUANG Jiajun, LIU Yueqiang, NI Xinjian, DING Zhiping, DENG Shouting, HU Bin

Unit:  Department of General Surgery, Boluo County People's Hospital, Boluo 516100, Guangdong, China

摘要：

目的  探讨加速康复外科合并肠内营养技术在老年腔镜胃癌手术的应用价值。方法  选取2014年1月至2017年12月我院67例老年胃癌手术患者作为研究对象,根据围手术期处理措施的不同分为两组,采用加速康复外科合并肠内营养措施的33例患者为试验组,采用传统围手术期处理方案的34例纳入对照组。观察两组患者术后首次肛门排气时间、首次排便时间、疼痛评分、平均静脉输液时间、术后住院时间、住院费用、术后并发症的情况、术后超敏C反应蛋白(hs-CRP)水平变化。结果  与对照组相比,试验组首次肛门排气时间[(55.56±2.36)h  vs. (76.32±9.57)h, P=0.026]、首次排便时间[(78.29±3.72)h vs. (99.31±6.79)h, P=0.017]、疼痛评分[(4.23±0.86)分vs. (7.36±1.35)分, P=0.008]、平均静脉输液时间[(5.33±1.41)d vs. (9.73±3.81)d, P=0.017]、术后住院时间[(6.95±1.38)d vs. (10.56±2.37)d, P=0.006]均缩短;住院费用减少[(37279.5±1156.3)元 vs. (43267.6±2252.4)元, P=0.001];术后并发症发生率降低[15.15% vs. 47.06%, P=0.008]。术后试验组患者的hs-CRP水平明显低于对照组(均P<0.05)。结论  加速康复外科合并肠内营养在老年腔镜胃癌根治术中应用是安全有效的,并且能够加速患者康复。

关键词： 加速康复外科; 肠内营养; 围手术期; 胃癌

Abstract：

Objective  To explore the clinical efficiency of enhanced recovery after surgery combine enteral nutrition in eldly gastric cancer surgery. Methods  From January 2014 to December 2017, sixtyseven patients with gastric cancer in our hospital were divided into two groups according to different perioperative management, 33 patients who had used enhanced recovery after surgery combine enteral nutrition in perioperative period were as experimental group. Other 34 patients who had used traditional protocol were as control group. We observed the postoperative time of the first anal exhaust, the first defecation time, pain scores, average venous transfusion time, postoperative length of stay, hospitalization expenses, postoperative complications, postoperative hypersensitive C-reactive protein level (hs-CRP). Results  In experimental group, the first anal exhaust time [(55.56±2.36)h vs. (76.32±9.57)h, P=0.026], the first defecation time [(78.29±3.72)h vs. (99.31±6.79)h, P=0.017], pain scores[(4.23±0.86)vs. (7.36±1.35), P=0.008], average venous transfusion time [(5.33±1.41)d vs. (9.73±3.81)d, P=0.017], postoperative length of stay [(6.95 ±1.38)d vs. (10.56±2.37)d, P=0.006] were shorter than those in control group. The hospitalization expenses [(37279.5±1156.3)Yuan vs. (43267.6±2252.4) Yuan, P=0.001], the incidence of postoperative complications [15.15% vs. 47.06%, P=0.008], the levels of hs-CRP in the experimental group were lower than those in the control group (P<0.05). Conclusions  Enhanced recovery after surgery combine enteral nutrition is safe and effective in promoting the post-operative recovery of eldly gastric cancer surgery.

Key Words:  Enhanced recovery after surgery; Enteral nutrition; Perioperative period; Gastric cancer