本文關(guān)鍵詞：加速康復(fù)外科理念用于胰十二指腸切除術(shù)臨床研究，，由筆耕文化傳播整理發(fā)布。

加速康復(fù)外科理念用于胰十二指腸切除術(shù)臨床研究

Clinical study of enhanced recovery after surgery for pancreatoduodenectomy

[1] [2] [3] [4] [5] [6] [7]

LI Min, WANG Xin-bo, WANG Si-zhen, et al. （Department of General Surgery, Research Institute of General Surgery of PLA, Nanjing General Hospital of Nanjing Military Command o

南京軍區(qū)南京總醫(yī)院普通外科解放軍普通外科研究所,江蘇南京210002

文章摘要：目的探討加速康復(fù)外科（ERAS）策略應(yīng)用于行胰十二指腸切除術(shù)（PD）病人的安全性、可行性和有效性。方法回顧性分析2008年1月至2014年9月南京軍區(qū)南京總醫(yī)院普通外科收治的281例行PD病人的臨床資料,根據(jù)治療策略不同將病人分為ERAS組（90例,圍手術(shù)期采用ERAS策略）和傳統(tǒng)組（191例,圍手術(shù)期按傳統(tǒng)方法治療）。對比分析兩組病人術(shù)中及術(shù)后情況。結(jié)果 ERAS組與傳統(tǒng)組的手術(shù)時間和術(shù)中出血量差異無統(tǒng)計學意義（P〉0.05）。ERAS組病人術(shù)后排氣時間、排便時間、靜脈補液時間、總住院時間及術(shù)后住院時間均縮短,術(shù)后進食時間和腹腔引流管拔除時間明顯提前,與傳統(tǒng)組差異均有統(tǒng)計學意義（P〈0.05）。兩組病人術(shù)后總并發(fā)癥發(fā)生率、各并發(fā)癥發(fā)生率、病死率、再手術(shù)率以及再住院率差異均無統(tǒng)計學意義（P〉0.05）。ERAS組病人再次入院的原因是C級胰瘺（1例）、胃排空障礙（2例）和切口感染（1例）;傳統(tǒng)組再次入院的原因為B級胰瘺（1例）、胃排空障礙（2例）、切口感染（1例）和腸梗阻（1例）。除C級胰瘺病人須行CT引導下穿刺引流術(shù)外,其余病人均通過保守治療治愈。結(jié)論 ERAS策略可安全有效地應(yīng)用于行PD病人,明顯縮短術(shù)后住院時間,且不增高術(shù)后并發(fā)癥發(fā)生率、病死率和再住院率。

Abstr：Objective To study the safety, feasibility and efficacy of enhanced recovery after surgery （ERAS） for pancreatoduodenectomy （PD） patients. Methods The clinical data of the 281 patients who underwent PD between January 2008 and September 2014 in Nanjing General Hospital of Nanjing Militancy Command of PLA were analyzed retrospectively. The patients were divided into ERAS （90 patients, treated with ERAS protocol） and conventional groups （191 patients, treated with conventional program） according to different treatments. The intraoperative and postoperative data were compared. Results There was no significant difference in operation time and operative blood loss between two groups （P〉0.05）. The days of first flatus, first stool and intravenous, length of stay （LOS） and LOS after operation in ERAS group were shorter than those in conventional group （P〈0.05）. Compared with conventional group, the patients in ERAS group had earlier food intake and drain removal （P〈0.05）. There was no significant difference in the rates of overall complication, special complication, relaparotomy, readmission and mortality between two groups （P〉0.05）. Four patients in ERAS group had readmission because of pancreatic fistula grade C （1 patient）, delayed gastric emptying （2 patients） and wound infection （1 patient）. Meanwhile, the number of readmission in conventional group was five （1 pancreatic fistula grade B, 2 delayed gastric emptying, 1 wound infection, 1 small bowel obstruction）. One patient who had pancreatic fistula grade C was treated with pereutaneous puncture draining guided by CT. The other readmitted patients were all cured with conservative treatment. Conclusion The ERAS pathway is feasible and safe for PD patients yielding a sh

文章關(guān)鍵詞：

Keyword：:enhanced recovery after surgery pancreas panereatoduodenectomy

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  本文關(guān)鍵詞：加速康復(fù)外科理念用于胰十二指腸切除術(shù)臨床研究，由筆耕文化傳播整理發(fā)布。