快速康复外科模式应用于结直肠癌患者围手术期60例效果评价

摘要

目的 探讨快速康复外科(FTS)模式应用于结直肠癌患者围手术期对促进患者康复的可行性和有效性.方法 前瞻性纳入就诊并接受外科手术治疗的结直肠癌患者60例,随机分为FTS组和对照组,FTS组按照FTS模式处理,对照组按照传统模式处理,比较2组患者术中生命体征、麻醉苏醒时间、术后并发症发生率等指标的差异.结果 与对照组比较,FTS组患者手术中心率、血压、中心静脉压等生命体征指标平稳且变化幅度小,自主呼吸恢复时间缩短、拔管时间提前、达到术后麻醉Steward苏醒评分4分时间缩短,全麻药物使用量及输血输液量少,术后镇痛效果好,且恶心、呕吐、腹胀、腹痛、尿潴留、肺部感染、下肢深静脉血栓、吻合口漏等术后并发症发生率并未增高.结论 FTS模式应用于结直肠癌患者围手术期可以有效改善机体状况,有利于患者康复.%Objective To probe into the feasibility and effectiveness of applying fast track surgery (FTS) model in patients with colorectal cancer in the perioperative period.Methods Our forward-looking group researched into 60 colorectal cancer patients who received treatment and surgical operation at The First Hospital of Lanzhou City from October 2014 to February 2016 and who were randomly divided into an observation group (FTS group) and control group.Patients in the FTS group received FTS-style management while those in the control group received normal management.Then,indicators such as vital sign,anesthesia waking time and rate of postoperative complications of two groups of patients were measured and compared.Results Vital signs such as heart rate,blood pressure and central venous pressure of patients during surgical operation in the FTS group,compared with those of patients in the control group,were steadier and changed in a smaller range.More specifically,spontaneous respiratory recovery time of patients in the FTS group was shorter,extubation time advanced and the time to reach 4 point in steward testing (anesthesia waking time rating) also shorter.Furthermore,in the FTS group,the amount of drug in total anesthesia use and blood transfusion or fluid infusion volume were less and postoperative analgesia effect was better.At the same time,the ratio of postoperative complications,such as nausea,vomiting,bloating,abdominal pain,urinary retention,pulmonary infection,deep venous thrombosis and anastomotic leakage,did not increase.Conclusion Applying FTS model in the patients with colorectal cancer in perioperative period can effectively improve their perioperative status and is,therefore,conducive to patients' recovery.