| 摘要: |
| 目的比较实施加速康复外科理念与传统外科理念对胃癌手术患者围术期的效果及术后胰岛素抵抗的影响，探讨加速康复外科的临床应用价值。方法选取2016年5至10月收治的拟行外科手术治疗的胃癌患者55例，其中5至7月收治的28例患者行传统外科理念下的胃癌手术，设为传统组；8至10月收治的27例患者行加速康复外科理念下的胃癌手术，设为加速康复组。比较两组患者术后并发症发生情况、住院时间、住院费用及手术前后稳态模式评估法计算的胰岛素抵抗指数（HOMA-IR指数）。结果加速康复组与传统组患者术后并发症发生率比较无统计学差异（18.5%vs21.4%，P＞0.05）。加速康复组患者住院时间短于传统组(P＜0.05)，住院费用低于传统组(P＜0.05)。两组患者术前HOMA-IR指数比较差异无统计学意义（P＞0.05）。术后1、3d加速康复组HOMA-IR指数均较传统组下降（均P＜0.05），术后7d两组HOMA-IR指数比较差异无统计学意义（P＞0.05）。结论在胃癌手术中实施加速康复外科理念，可以减轻患者术后胰岛素抵抗，缩短住院时间，减少住院费用，且不会提高术后并发症发生率，值得临床推广应用。 |
| 关键词: 加速康复外科 胃癌 胰岛素抵抗 手术 |
| DOI：10.12056/j.issn.1006-2785.2018.40.14.2017-3137 |
| 分类号: |
| 基金项目:丽水市科技计划项目（2016zdyf01） |
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| Effects of enhanced recovery after surgery (ERAS) for patients with gastric cancer |
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the Fifth Affiliated Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To compare the effect of enhanced recovery after surgery (ERAS) and traditional surgery for patients with gastric cancer. Methods Fifty five patients with gastric cancer undergoing surgical treatment from May 2016 to October 2016 were enrolled in the study, including 28 patients receiving traditional protocol of postoperative rehabilitation (traditional group) and 27 patients receiving ERAS protocol (ERAS group). The incidence of postoperative complications, length of hospital stay and medical expenses were compared between two groups; and the insulin resistance indices (HOMA-IR index) was calculated before and after operation in two groups. Results There was no statistically significant difference in the incidence of postoperative complications between ERAS group and traditional group (18.5% vs 21.4%, P ＞0.05). In the ERAS group, the length of hospital stay was shorter than that in traditional group (P＜0.05), and the medical cost was lower than that in the traditional group (P ＜0.05). There was no significant difference in preoperative HOMA-IR indices between two groups (P ＞0.05). In postoperative 1d and 3d, HOMA-IR indices of ERAS group were significantly lower than those of the traditional group (P＜0.05), while there was no significant difference 7d after the operation (P ＞0.05). Conclusion ERAS protocol during gastric cancer
surgery can decrease the postoperative insulin resistance, shorten the length of hospital stay, reduce the medical expenses, while not increase the postoperative complication rate for patients with gastric cancer. |
| Key words: Enhanced recovery after surgery Gastric cancer Insulin resistance Surgery |
