作　　者： (叶松）;

机构地区： 江苏省沭阳人民医院,223600

出　　处： 《实用癌症杂志》 2017年第9期1511-1514,共4页

摘　　要： 目的探讨加速康复外科(ERAS)理念对青中年胃癌手术治疗近远期疗效的影响。方法将85例青中年胃癌患者按入院时间不同随机分为2组,对照组为38例,实验组为47例。对照组接受传统概念下的围手术期处理,而实验组则接受加速康复外科理念下的围手术期处理。记录并观察2组患者的手术时间、术中出血量、术后并发症、住院时间及费用以对比分析不同围手术期处理方式的近期疗效;通过电话、门诊复诊、上门回访等方法进行随访,了解2组患者的生存状态及生活质量,采用生活质量核心问卷(QLQ-C30)进行评估,以对比分析不同围手术期处理方式的远期疗效。结果与对照组比较,实验组手术时间及住院时间相对缩短,术中出血量相对减少,住院费用相对降低,术后并发症发生率也相对降低,差异均具有统计学意义(P<0.05)。对照组的3年生存率是47.37%,实验组的3年生存率是68.09%,但差异无统计学意义(χ~2=3.383,P=0.066)。与对照组比较,实验组整体健康及生活质量量表评分和功能量表评分相对升高,而症状量表评分和单项测量项目评分相对减低,且差异均具有统计学意义(P<0.05)。结论加速康复外科的围手术处理不仅可以优化手术过程、减少术后并发症、加快恢复进程,还可提升远期生活质量及生存率,有一定的应用价值。 Objective To explore the effect of enhanced recovery after surgery（ ERAS） on short-term and long-term efficacy of surgical treatment for young and middle-aged patients with gastric cancer. Methods 85 young and middle-aged patients with gastric cancer were randomly divided into 2 groups according to the time of admission,the control group was 38,and the experimental group was 47. The control group received the traditional perioperative management,while the experimental group received accelerated rehabilitation surgery in the perioperative management. Operative time,intraoperative blood loss,postoperative complications,length of stay and cost of the 2 groups were recorded and compared; all patients were followed up by telephone,outpatient visits,home visits and other methods to understand and compare the survival and quality of life（ QLQ-C30） in the 2groups. Results Compared with the control group,the operation time,hospitalization time,the intraoperative blood,the hospitalization expenses and the incidence of postoperative complications in the experimental group were lower,the differences were statistically significant（ P〈0. 05）. 3-year survival rate of the control group was 47. 37%,but the survival rate of the experimental group was 68. 09%,it was obvious that the survival rate of the experimental group was higher than that of the control group,but the difference was not statistically significant（ χ~2= 3. 383,P = 0. 066）. Compared with the control group,the overall health and quality of life score and function score were more increased in the experimental group,and the symptom scale and single measurement score were more decreased,and the differences were statistically significant（ P〈0. 05）. Conclusion ERAS can optimize the operation process,reduce postoperative complications,speed up the recovery process,and can improve the quality of life and survival rate.

关 键 词： 加速康复外科 青中年胃癌 术后并发症 生活质量 生存率