快速康复外科理念用于胃节段切除术治疗早期胃癌的临床评价

目的探讨快速康复外科理念(ERAS)用于胃节段切除术治疗早期胃癌的临床效果。方法回顾性队列分析2017年8月至2020年11月接受胃节段切除术的87例早期胃癌患者临床资料,根据围术期是否应用ERAS理念分为ERAS组(47例,应用ERAS理念)和传统组(40例,传统外科康复理念)。采用SPSS 23.0统计分析软件,术后恢复指标、营养状况、疼痛程度、QLQ-C30量表评分以(±s)表示,独立t检验;并发症用χ²检验。P<0.05为差异有统计学意义。结果ERAS组肠音恢复时间、肛门排气时间、首次排便时间、切口愈合时间、术后住院时间均比传统组短(P<0.05)。术后7 d ERAS组自评-主观全面评定量表(PG-SGA)总分、视觉模拟评分法(VAS)评分比传统组低(P<0.05)。术后12周ERAS组QLQ-C30量表各维度评分均比传统组高(P<0.05)。ERAS组术后并发症总发生率为12.8%比传统组30.0%低(P<0.05)。结论ERAS理念用于胃节段切除术治疗早期胃癌可加速术后恢复进程,缓解疼痛,改善术后营养状况及生存质量,临床应用价值高。

Clinical evaluation of enhanced recovery after surgery in the treatment of early gastric cancer by segmental gastrectomy

Objective To investigate the clinical effect of enhanced recovery after surgery(ERAS)in the treatment of early gastric cancer by segmental gastrectomy.Methods A retrospective cohort study was conducted in 87 patients with early gastric cancer who underwent segmental gastrectomy from August 2017 to November 2020,the clinical data were analyzed.The patients were divided into ERAS group(47 cases)and traditional group(40 cases)according to the perioperative managements.Statistical analysis were performed by using SPSS 23.0 software.Measurement data such as postoperative recovery index,nutritional status,pain degree and scores of QLQ-C30 were expressed as,and analyzed by using independent t-test,and the complications were analyzed by using chi square test.A P value of<0.05 was statistically significant difference.Results The recovery time of bowel movement,anal exhaust time,first defecation time,incision healing time and postoperative hospital stay in ERAS group were shorter than those in traditional group respectively(P<0.05).The total score of visual analogue scale(VAS)and self-evaluation subjective comprehensive assessment scale(PG-SGA)were lower than those in traditional group respectively(P<0.05).After 12 weeks,the scores of QLQ-C30 in ERAS group were higher than those in traditional group(P<0.05).The total incidence of postoperative complications in ERAS group was 12.8%,which was lower than 30.0%in traditional group(P<0.05).Conclusion The concept of ERAS in the treatment of early gastric cancer by segmental gastrectomy could accelerate the process of postoperative recovery,relieve pain,improve postoperative nutritional status and quality of life.