标题：快速康复外科理念在老年人腹腔镜胃癌手术中的应用

      作者：王宏伟，辛乐，汤明生，刘宜宾，阎玉矿    深圳市龙岗中心医院普外科，广东 深圳 518000

      卷次： 2021年32卷7期

      【摘要】 目的 探讨快速康复外科理念在老年人腹腔镜胃癌手术中的应用效果。方法 前瞻性选取深圳市龙岗中心医院普外科2018年12月至2019年12月收治的60例拟行腹腔镜胃癌手术的老年患者作为研究对象，按随机数表法将其分为观察组和对照组各30例。对照组患者采用传统胃癌根治术围手术期处理方法，观察组患者在快速康复外科理念下进行围手术期处理。比较两组患者的手术时间、手术出血量、术后并发症(营养不良、发热、恶心呕吐、喉咙痛及肺部感染、吻合口瘘及出血)以及术后肛门排气时间、住院时间和再次住院率。结果 观察组和对照组患者的手术时间[(139.81±21.53) min vs (144.13±21.29) min]、手术出血量[(87.46±12.81) mL vs (88.75±13.78) mL]、再次住院率(6.67% vs 26.67%)比较差异均无统计学意义(P>0.05)；观察组患者术后肛门排气时间和住院时间分别为(1.41±0.13) d、(4.43±0.29) d，明显短于对照组的(4.43±0.29) d、(24.75±6.78) d，差异均有统计学意义(P<0.05)；观察组患者出现营养不良、发热、恶心呕吐、喉咙痛等并发症的总发生率为16.67%，略低于对照组的26.67%，但差异无统计学意义(P>0.05)。结论 快速康复外科理念应用于老年人腹腔镜胃癌手术中能缩短患者的住院时间，促进术后快速康复，减少术后并发症。
      【关键词】 老年；胃癌；快速康复外科理念；腹腔镜；吻合口瘘；围术期
      【中图分类号】 R735.2 【文献标识码】 A 【文章编号】 1003—6350（2021）07—0889—03

Application of the concept of rapid rehabilitation surgery in the elderly laparoscopic gastric cancer surgery.WANG Hong-wei, XIN Le, TANG Ming-sheng, LIU Yi-bin, YAN Yu-kuang.
Department of General Surgery, ShenzhenLonggang Central Hospital, Shenzhen 518000, Guangdong, CHINA
【Abstract】 Objective To explore the application effect of the concept of rapid rehabilitation surgery in the el-derly laparoscopic gastric cancer surgery. Methods A total of 60 elderly patients with gastric cancer, who underwentlaparoscopic surgery in Department of General Surgery, Shenzhen Longgang Central Hospital from December 2018 toDecember 2019, were prospectively selected as the research objects and randomly divided into the observation groupand the control group with 30 cases in each group. The patients in the control group were treated with traditional radicalgastrectomy, while the patients in the observation group were treated with rapid rehabilitation surgery. The operationtime, surgical blood loss, postoperative complications (malnutrition, fever, nausea and vomiting, sore throat and lung in-fection, anastomotic leakage and bleeding), and postoperative anal exhaust time, hospitalization time and re-hospitaliza-tion rate of the two groups were compared. Results There were no significant differences in operation time with(139.81±21.53) min vs (144.13±21.29) min, blood loss with (87.46±12.81) mL vs (88.75±13.78) mL, readmission ratewith 6.67% vs 26.67% between the two groups (all P>0.05); the postoperative anal exhaust time and hospital stay of theobservation group were (1.41±0.13) d and (4.43±0.29) d, which were significantly shorter than corresponding (4.43±0.29) d and (24.75±6.78) d of the control group (P<0.05); the total incidence of malnutrition, fever, nausea, vomiting,and sore throat in the observation group was 16.67%, which was slightly lower than 26.67% of the control group (P>0.05). Conclusion The application of rapid rehabilitation surgery concept in nursing care of elderly patients with lapa-roscopic gastric cancer surgery can shorten the hospitalization time, promote rapid postoperative recovery, reduce thepostoperative complications.
      【Key words】 Elderly; Gastric cancer; Rapid rehabilitation surgery concept; Laparoscopy; Anastomotic leakage;Perioperative period·短篇论著·doi:10.3969/j.issn.1003-6350.2021.07.019基金项目：广东省深圳市龙岗区经济与科技发展专项资金(编号：LGKCYLW2018000038)