早期进食快速康复外科在胃肿瘤手术患者中的应用研究

目的 观察早期进食快速康复外科对胃肿瘤手术患者应激、营养及恢复的影响.方法 86例胃肿瘤患者随机分为快速康复外科组(FTS组)46例和传统组40例,FTS组在围术期采取一系列快速康复外科处理措施,包括早期进食,而传统组按常规围术期处理.观察两组间应激反应、营养状况、免疫水平及肠道功能恢复情况等.结果 FTS组的IR指数和C反应蛋白在术后第1天低于传统组,差异有显著性(P＜0.05)；两组患者术后第1天IgG和IgA均下降,但FTS组术后第6天IgG和IgA恢复较快,且超过术前水平,与传统组比较差异有显著性；FTS组术后下地活动时间、术后排气排便时间与对照组相比均明显提前或缩短,差异有显著性(P＜0.05);两组均未见围术期严重并发症.结论 FTS能减轻胃肿瘤手术患者的应激反应、改善术后免疫状况、能促进患者肠道功能的恢复.早期进食安全可行.

Effect of early eating of fast-track surgery in surgical patients with gastric cancer

【Objective】 To study the effect of early eating of fast-track surgery on surgical stress,nutrition and recovery of patients with gastric cancer surgery.【Methods】 86 patients with gastric cancer surgery were divided randomly into FTS group(n =46) and control group(n =40),which were treated with fast-track surgery and traditional methods respectively.The data of stress,nutritional status,immune,and intestinal function recovery after surgery were evaluated.【Results】 IR index and C-reactive protein of FTS group on day 1 after surgery were significantly lower than that of the traditional group’s;meanwhile,the levels of IgG and IgA in two groups were decrease,but it recovered faster at day 6 in FTS group,compared with the traditional group;and the recovery time were shorter in FTS group than that of control group;Both groups were no acutely perioperative complications.【Conclusion】 For patients with gastric cancer surgery,the fast-track surgery can lighten stress response,improved immune status,can promote bowel function recovery.Early eating is safe and feasible.