本文選題：遠(yuǎn)端胃癌　切入點(diǎn)：腹腔鏡輔助　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:評(píng)價(jià)在加速康復(fù)外科(Enhanced recovery after surgery ERAS)指導(dǎo)下的腹腔鏡輔助遠(yuǎn)端胃癌根治術(shù)的可行性和有效性。方法:選取山西省腫瘤醫(yī)院2016年4月至2016年11月符合條件擇期行遠(yuǎn)端胃癌手術(shù)的患者,按入院時(shí)間的先后隨機(jī)單雙編號(hào),奇數(shù)納入傳統(tǒng)處理組,偶數(shù)納入加速康復(fù)組,共納入60例患者,其中,傳統(tǒng)處理組30例,加速康復(fù)組30例。分別記錄兩組患者的術(shù)前相關(guān)資料:年齡、性別、體重、BMI、術(shù)前1天血清白蛋白水平(ALB);手術(shù)相關(guān)的資料:手術(shù)時(shí)間、吻合方式、術(shù)中總出血量;術(shù)后相關(guān)資料:術(shù)后兩組患者的TNM分期、術(shù)后肛門排氣時(shí)間、術(shù)后住院時(shí)間、住院總費(fèi)用、并發(fā)癥發(fā)生情況、術(shù)后第4天、第7天血清白蛋白水平。并對(duì)兩組數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析、比較。結(jié)果:兩組患者間的年齡、性別、體重、BMI、術(shù)前1天ALB水平、手術(shù)時(shí)間、吻合方式、術(shù)中總出血量、術(shù)后患者的TNM分期、并發(fā)癥發(fā)生情況均無(wú)顯著性差異(P均0.05);術(shù)后ALB水平ERAS組較傳統(tǒng)組高,且變化更平穩(wěn)、術(shù)后肛門排氣時(shí)間ERAS組較傳統(tǒng)組快、住院總費(fèi)用ERAS組較傳統(tǒng)組少,差異均有統(tǒng)計(jì)學(xué)意義(P均0.05);術(shù)后平均住院時(shí)間ERAS組(8.87±1.80天)較傳統(tǒng)組(9.47±1.52天)略短,但比較無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.兩組患者相比較,ERAS組較傳統(tǒng)組在減輕患者的應(yīng)激反應(yīng)、促進(jìn)胃腸道功能恢復(fù)、降低住院費(fèi)用等方面有一定的優(yōu)勢(shì)。2.ERAS理念應(yīng)用于腹腔鏡輔助遠(yuǎn)端胃癌根治術(shù)中是安全、可靠的。
[Abstract]:Objective: to evaluate the feasibility and effectiveness of laparoscopic assisted radical gastrectomy for distal gastric cancer under the guidance of accelerated recovery after surgery ERASA.Methods: patients with distal gastric cancer were selected from April 2016 to November 2016 in Shanxi Cancer Hospital. According to the time of admission, the patients were assigned to the traditional treatment group with odd number, and even number into the accelerated rehabilitation group.A total of 60 patients were included, including 30 cases in traditional treatment group and 30 cases in accelerated rehabilitation group.The preoperative data of the two groups were recorded: age, sex, body weight, serum albumin level and ALBX on one day before operation, operation time, anastomosis mode, total blood loss during operation;Postoperative data: TNM stage, postoperative anal exhaust time, postoperative hospitalization time, total cost of hospitalization, complications, serum albumin level on the 4th and 7th day after operation in the two groups.And the two groups of data were statistically analyzed and compared.Results: age, sex, body weight, preoperative ALB level, operation time, anastomosis mode, total blood loss during operation, TNM staging of the patients after operation were compared between the two groups.The postoperative ALB level in ERAS group was higher than that in traditional group, and the change was more stable. The postoperative anal exhaust time in ERAS group was faster than that in traditional group, and the total cost of hospitalization in ERAS group was less than that in traditional group.The average postoperative hospitalization time in ERAS group was 8.87 鹵1.80 days, which was slightly shorter than that in traditional group (9.47 鹵1.52 days), but there was no significant difference between the two groups.Conclusion 1.Compared with the traditional group, the ERAS group has some advantages in reducing the stress response, promoting the recovery of gastrointestinal function and reducing the cost of hospitalization. 2. It is safe and reliable to apply the ERAS concept in laparoscopic assisted distal gastric cancer radical operation.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.2

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