快速康复在腹腔镜胃癌根治围手术期的临床应用

目的 评价快速康复外科（fast track surgery,FTS）理念在腹腔镜胃癌根治围手术期的临床应用.方法 收集2012年12月至2013年6月80例择期胃恶性肿瘤病人,随机分为快速康复组（FTS组）和传统治疗组.比较两组病人术后疼痛程度、排气时间、术后住院天数、并发症、住院费用及炎性因子白细胞介素（IL）6、IL-8、C反应蛋白（CRP）、肿瘤坏死因子（TNF-α）的差异.结果 FTS组病人术后疼痛评分和排气时间分别为（2.0±0.3）分和（55±3.3）h,低于对照组的（2.7±0.4）分和（72±6.5）h（P＜0.01）,术后住院时间和总费用分别为（5.6±0.6）d和（2.9±0.4）万元,均低于对照组的（7.5±0.7）d和（3.5±0.6）万元（P＜0.05）,术后炎性因子指标上升幅度较对照组均降低（P＜0.05）,两组术后并发症发生率差异无统计学意义（P＞0.05）.结论 FTS理念应用于腹腔镜胃癌根治围手术期可减轻术后疼痛、减轻炎症应激反应、促进胃肠道功能恢复、缩短住院时间及降低总费用,加速了病人术后康复,值得临床推广应用.

Clinical application of fast track surgery with laparoscope in the treatment for gastric cancer

Objective To evaluate clinical application of fast track surgery in the treatment for gastric cancer with laparoscopic surgery.Methods From December 2012 to June 2013,80 cases of gastric cancer were randomized into fast track and conventional care groups.We compared the difference of postoperative pain,postoperative flatus time,postoperative hospital stay,postoperative complications,hospitalization expenditure and inflammatory factors （interleukin-6,interleukin-8,C-reactive protein ＆ tumor necrosis factor-alpha）.Results The time of postoperative pain and the time of anal exsufflation were （2.0 ± 0.3） and （55 ± 3.3） hours respectively.And both were lower than those of control group （P＜0.01）.The durations of postoperative hospital stay and hospitalization expenditure were （5.6 ± 0.6） and （2.9 ± 0.4） days respectively and both were lower than those of normal control group （P＜ 0.05）.The increments of inflammatory factors were smaller than those of control group （P＜0.05）.However,there were no inter-group differences in postoperative complications （P＞0.05）.Conclusions For gastric cancer patients,fast track surgery with laparoscopic surgery may decrease the postoperative pain,suppress inflammation stress reaction,promote gastrointestional function recovery,shorten postoperative hospital stay,reduce hospitalization expenditure and accelerate patient recovery.It is worthy of further clinical poplarization.