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目的探讨快速康复外科理念在腹腔镜全胃切除术围手术期中的安全性和可行性。方法将2013年1月~2016年12月住院的106例行腹腔镜全胃切除的胃癌患者随机分为观察组和对照组。观察组围手术期严格遵循快速康复外科理念(n=48),对照组围手术期按传统方法处置(n=58)。比较两组术后临床效果及并发症发生率。结果观察组术后首次排气时间、首次排便时间、术后输液时间、术后住院时间、住院总费用明显少于对照组,两组比较差异均具有统计学差异(P<0.05);在术后肠梗阻、吻合口出血发生率、吻合口漏发生率、切口感染率比较,两组差异无统计学意义(P>0.05);观察组在呃逆、呕吐发生率、肺部并发症发生率、泌尿系统感染发生率、深静脉血栓发生率明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论快速康复外科理念应用于腹腔镜全胃切除术安全、有效,有助于促进患者术后康复,减少住院时间和住院费用,减轻了患者的经济压力,值得推广。
Objective To investigate the safety and feasibility of rapid rehabilitation surgery in the perioperative period of laparoscopic total gastrectomy. Methods From January 2013 to December 2016, 106 patients undergoing laparoscopic total gastrectomy for gastric cancer were randomly divided into observation group and control group. In the observation group, the concept of rapid rehabilitation surgery was strictly followed during perioperative period (n = 48), while the control group was treated perioperatively (n = 58). The clinical effects and complication rates were compared between the two groups. Results The first postoperative exhaust time, first defecation time, postoperative infusion time, postoperative hospital stay and hospitalization cost were significantly less in the observation group than in the control group, with significant difference between the two groups (P <0.05) Intestinal obstruction, anastomotic bleeding rate, anastomotic leakage rate, incision infection rate comparison between the two groups was not statistically significant (P> 0.05); the observation group in the hiccups, vomiting, the incidence of pulmonary complications, The incidence of urinary tract infection, deep venous thrombosis was significantly better than the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion The concept of rapid rehabilitation surgery applied to laparoscopic total gastrectomy is safe and effective, which helps to promote postoperative recovery, reduce hospitalization time and hospitalization costs, and alleviate the economic pressure of patients. It is worth to be popularized.