根治性全胃切除术患者应用快速康复外科的研究-外科学(普外)专业论文.docx

安徽医 安徽医科大学硕士学位论文 PAGE PAGE 5 缩略词表(Abbreviation) 英文缩写 FTS 英文全称 fast track surgery 中文名 快速康复外科 CRP C-reactive protein C 反应蛋白 IL-6 interleukin-6 白介素-6 ALB PA serum albumin prealbumin 血清白蛋白 前白蛋白 TRF transferrin 转铁蛋白 根治性全胃切除术患者应用快速康复外科的研究 摘 要 目的 将 FTS 理念应用于根治性全胃切除术的患者的围手术期管理，观察其安全 性及有效性。 方法 选择 2010 年-2012 年在我科行根治性全胃切除术的 40 名胃癌患者，对其围 手术期采取 FTS 模式管理，另选 40 例胃癌患者对其采取传统方式治疗，比较两组 术后临床指标、营养指标和应激指标。 结果 FTS 组同传统组相比，术后首次通气时间、住院时间及住院费用均降低 （P0.05）；肺部并发症均显著降低，差异有统计学意义（P0.05）；而呕吐、腹胀 等消化道症状、吻合口瘘、腹腔积液发生率未见明显升高（P0.05），总体术后并 发症发生率比较，FTS 组稍低于传统组，但差异无统计学意义（P0.05）；FTS 组 患者术后白蛋白、前白蛋白、转铁蛋白下降程度明显较传统组小，且回升较快 （P0.05）；应激方面，FTS 组 CRP、IL-6 术后上升幅度较小，术后能迅速下降至 正常（P0.05）；再入院率比较，FTS 组高于传统组，差异无统计学差异（P0.05）。 结论 FTS 应用于胃癌围手术期管理安全有效，可促进患者快速康复，并不增加 术后并发症的发生率。 关键词 胃癌 快速康复外科 Research of Fast Track Surgery in Patients with Radical Total Gastrectomy during Perioperative Period Abstract Objective To evaluate the safety and effecting of fast track surgery using in patients with radical total gastrectomy during perioperative period. Methods Chose forty gastric cancer patients with radical total gastrectomy receiving fast track surgery，chose another forty gastric cancer patients receiving traditional surgery. Compare respectively the postoperative clinical indicators, nutrition indicators and stress indicators. Results The passage of gas by anus, time of hospital stay and treatment expense in patients of fast track group were lower than those in traditional group(P0.05). The postoperative complications of lung in patients in fast track group were significantly lower than those in traditional group(P0.05). Patients in fast track group had no more complications than those in traditional group in vomiting, abdominal distension, anastomotic leakage and seroperitoneum(P0.05). There were no significant differences in total postoperative complications between the two groups(P0.05). The postoperative serum levels of nutrition indicators,such as albumin, prealbumin, transferrin, in fast track group is significantly lower