作者：刘彦合，姬安龙，傅祥炜，曾祥勇

单位：海南医学院第二附属医院 普通外科， 海南 海口 570311

Authors: Liu Yanhe, Ji Anlong, Fu Xiangwei, Zeng Xiangyong

Unit: General Surgery, the Second Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan, China

摘要：

目的 探究加速康复联合肠内支架在梗阻性结直肠癌中的应用效果。方法 选取2018年1月到2021年1月海南医学院第二附属医院收治的100例梗阻性结直肠癌患者，采用随机数字表法将其分为对照组（n=50）和观察组（n=50），两组均行内镜下支架植入手术，其中对照组采用传统腹腔镜围手术期处理，观察组采用加速康复外科围手术期处理，对比两组患者的手术时间、术中出血量、术后肛门排气时间、住院时间、住院费用、应激指标、术后并发症发生情况。结果 观察组的手术时间、术中出血量、术后肛门排气时间、住院时间、住院费用优于对照组，差异具有统计学意义（P<0.05）；观察组患者的术后24 h、3 d的血糖、C反应蛋白水平明显低于对照组，差异具有统计学意义（P<0.05）；观察组患者的并发症总发生率明显低于对照组，差异具有统计学意义（P<0.05）。结论 对行内镜下肠内支架植入手术的梗阻性结直肠癌患者进行加速康复外科围手术期处理，可有效提升患者的手术疗效，改善患者的围手术期指标，减少相关并发症的发生率。

关键词：加速康复； 肠内支架植入； 围手术期； 梗阻性； 结直肠癌

Abstract：

Objective To explore the application effect of enhanced recovery combined with enteral stent in obstructive colorectal cancer. Method A total of 100 patients with obstructive colorectal cancer admitted to the Second Affiliated Hospital of Hainan Medical University from January 2018 to January 2021 were selected and divided into control group（n=50） and observation group（n=50） by random number table method. Both groups received endoscopic stent implantation. The control group received traditional laparoscopic perioperative treatment，and the observation group received perioperative treatment by enhanced recovery after surgery. The operation time，intraoperative blood loss，postoperative anal exhaust time，hospital stay and hospital expenses，stress index，occurrence of postoperative complications of the two groups were compared. Result The operation time，intraoperative blood loss，postoperative anal exhaust time，hospital stay and hospital expenses in the observation group were significantly lower than those in the control group （P<0.05）. The levels of blood glucose and CRP in observation group 24 h and 3 d after operation were significantly lower than those in control group ，with statistical significance （P<0.05）. The incidence of complications in observation group was significantly lower than that in control group，and the difference was statistically significant（P<0.05）. Conclusion Perioperative management of enhanced recovery after surgery for patients with obstructive colorectal cancer undergoing endoscopic enteral stent implantation can effectively improve the surgical efficacy of patients，improve the perioperative indexes of patients，and reduce the incidence of related complications.

Key Words: Enhanced recovery; Intestinal stent implantation; Perioperative period; Obstruction; Colorectal cancer