本文選題：快速康復外科(FTS)　切入點：胃癌　出處：《山西醫(yī)科大學》2014年碩士論文

【摘要】：目的探討快速康復外科(FTS)理念在胃癌行全胃切除圍手術(shù)期應用的效果及其與傳統(tǒng)圍手術(shù)期治療方法相比的優(yōu)越性。 方法選取山西醫(yī)科大學附屬晉煤集團總醫(yī)院從2012年6月至2014年3月間,胃癌患者行全胃切除術(shù)30例作為FTS組,另選取同期胃癌患者行全胃切除術(shù)圍手術(shù)期使用傳統(tǒng)方法30例作為對照組。兩組患者的手術(shù)操作和麻醉均由同一組外科醫(yī)師和同一組麻醉師進行。分析FTS組和傳統(tǒng)組在手術(shù)相關(guān)指標(手術(shù)時間、術(shù)中出血量、術(shù)后第3天C反應蛋白水平、引流管拔管時間)和術(shù)后恢復指標(肺部感染、腸鳴音恢復時間、首次排氣恢復時間、靜脈輸液天數(shù),術(shù)后并發(fā)癥、住院時間、費用及術(shù)后2周體重減輕量)的異同。 結(jié)果兩組病人均痊愈出院,FTS治療組與傳統(tǒng)方法治療組相比,術(shù)后首次排氣時間、腸鳴音恢復時間均明顯提前,靜脈輸液天數(shù)、術(shù)后兩周體重減輕量、住院費用及住院時間、術(shù)后并發(fā)癥均明顯減少(P0.05)；FTS對應激的改善作用優(yōu)于傳統(tǒng)方法,但兩組肺部感染比較無明顯差異(P0.05)。 結(jié)論1.應用FTS理念于胃癌行全胃切除患者圍手術(shù)期是安全的,可有效促進患者術(shù)后康復,減少術(shù)后并發(fā)癥發(fā)生； 2.與傳統(tǒng)圍手術(shù)期方法比較,全胃切除應用FTS理念,可提高患者滿意度,減輕患者圍手術(shù)期的創(chuàng)傷和應激反應,減輕患者圍手術(shù)期的痛苦,促進患者的早期康復�？s短患者住院時間、減少術(shù)后并發(fā)癥、改善患者術(shù)后器官功能、降低治療費用、加快床位的周轉(zhuǎn)率。
[Abstract]:Objective to investigate the effect of fast rehabilitation surgery (FTS) in the perioperative period of total gastrectomy for gastric cancer and its superiority compared with the traditional perioperative treatment. Methods from June 2012 to March 2014, 30 patients with gastric cancer underwent total gastrectomy as FTS group. In addition, 30 patients with gastric cancer undergoing total gastrectomy during perioperative period were selected as control group. The operation and anaesthesia of the two groups were performed by the same group of surgeons and anesthesiologists. The FTS group and the transmission group were analyzed. The related indexes of operation (operation time, operation time, Blood loss during operation, C-reactive protein level on the 3rd day after operation, drainage tube extubation time) and postoperative recovery indexes (pulmonary infection, recovery time of bowel sound, time of first exhaust recovery, days of intravenous infusion, postoperative complications, hospitalization time), Cost and weight loss 2 weeks after operation) similarities and differences. Results compared with the traditional treatment group, the first exhaust time and the recovery time of the bowel sound in the FTS treatment group were significantly earlier than those in the traditional treatment group. The days of intravenous infusion, weight loss, hospitalization cost and hospitalization time were also observed in the two groups. The effect of FTS on stress was better than that of traditional methods, but there was no significant difference in pulmonary infection between the two groups. Conclusion 1. It is safe to apply FTS concept to the patients with gastric cancer undergoing total gastrectomy, which can effectively promote postoperative rehabilitation and reduce postoperative complications. 2. 2.Compared with the traditional perioperative method, the application of FTS in total gastrectomy can improve the patients' satisfaction, reduce the trauma and stress response of the patients during perioperative period, and relieve the pain of the patients during perioperative period. To promote the early rehabilitation of patients, shorten the hospitalization time, reduce postoperative complications, improve postoperative organ function, reduce the cost of treatment, speed up the rate of bed turnover.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R735.2

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