快速康复外科对直肠癌患者改良型横切口根治术术后预后的影响

目的探讨快速康复外科（fast track surgery，FTS）对直肠癌患者改良型横切口根治术术后预后的影响。 方法选取2016年1月至2018年3月，阜新市第二人民医院接受治疗的直肠癌患者136例，采用随机数字表法将患者分为研究组和对照组，每组患者68例。2组患者均接受改良型横切口根治术，对照组围术期给予常规护理，研究组在FTS指导下进行护理。比较2组患者术后胃肠功能相关指标、术前及出院后2个月抑郁/焦虑状态，记录术后并发症发生情况。 结果与对照组比较，研究组术后肠鸣音恢复时间、肛门排气时间、进食时间及首次排便时间均明显提前，血浆胃动素水平明显升高（P<0.01）。与术前比较，出院后2个月2组患者抑郁自评量表和焦虑自评量表评分均明显降低，且研究组明显低于对照组（P<0.01）。研究组总并发症发生率明显低于对照组（P<0.05）。 结论在FTS理念指导下的围术期护理可明显缓解行改良型横切口根治术的直肠癌患者围术期不良心理情绪，促进患者术后肠道功能恢复，减少并发症，改善患者预后。

Effect of fast track surgery on prognosis of patients with rectal cancer after modified transverse incision surgery

ObjectiveTo explore the effect of fast track surgery (FTS) on prognosis of patients with rectal cancer after modified transverse incision surgery. Methods136 patients with rectal cancer who were treated in Fuxin Second peoples’ hospital from January 2016 to March 2018 were selected and divided into the experiment group and the control group by random number table method, 68 cases in each group. The 2 groups underwent modified transverse incision surgery. The control group received routine nursing during the perioperative period, while the experiment group underwent nursing under the guidance of FTS. The postoperative gastrointestinal function related indexes, the depression and anxiety status at preoperative and 2 months after discharged were compared between the 2 groups, and the postoperative complications were recorded. ResultsCompared with the control group, the recovery time of bowel sounds, anal exhaust time, eating time and first defecation time significantly advanced in the experiment group, the level of plasma MTL significantly increased (P<0.01). Compared with preoperative, the scores of SDS and SAS significantly decreased at 2 month after discharge in the 2 groups, and the experiment group was significantly lower than the control group (P<0.01). The incidence of total complications in the experiment group was significantly lower than that in the control group (P<0.05). ConclusionPerioperative nursing under the guidance of FTS concept can significantly alleviate the perioperative adverse psychological emotions of patients with rectal cancer undergoing modified transverse incision surgery, promote postoperative gastrointestinal function recovery, reduce complications and improve patient prognosis.