快速康复外科在高龄结肠癌患者中的应用

摘要

Objective To evaluate the safety and efficiency of fast tract surgery(FTS)in elder patients(more than 75 years old)receiving laparoscopic radical resection of colon cancer.Methods Eighty elder patients with colon cancer undergoing laparoscopic colectomy were divided into two groups:FTS group(n=40)and conventional care group(n=40).Main outcome measure including the postoperative first flatus time,postoperative hospital stay and complication rate.Statistical difference was evaluated via t test and chi-square testResults.All patients participated in this trial were cured.Compared to the conventional group,patients in FTS group had significantly earlier first flatus and shorter postoperative hospital stay(P<0.05).The incidence of postoperative complication in FTS was significantly higher than in conventional group(P<0.01).Conclusion FTS can effectively accelerate postoperative rehabilitation,shorten hospital stay In elder patients.But in postoperative complications,elder people cannot benefit from FTS.Therefore,popularization of FTS in elder patients should be more careful.%目的 评价快速康复(FTS)在接受腹腔镜辅助下高龄(>75岁)结肠癌根治术患者中的安全性与有效性.方法 接受腹腔镜辅助结肠癌根治术的高龄患者80例,将80例患者分为FTS组与传统组,每组各40例.FTS组患者接受围术期快速康复方案管理,传统组接受常规围术期管理.比较两组患者术后首次通气时间、术后住院时间、术后并发症发生率等.结果 所有患者均痊愈出院.与传统组患者比较,FTS组通气时间提前,住院时间缩短,差异有统计学意义(P<0.05).FTS组患者术后呕吐、腹泻及肠梗阻发生率明显上升(P<0.01).结论 在高龄患者中,FTS的运用可以缩短通气时间,减少住院时间,但在术后并发症方面,FTS并不能使高龄患者获益.在高龄结肠癌患者中推广FTS应慎重.