本文選題：加速康復(fù)外科 + 腹腔鏡��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:探討加速康復(fù)外科聯(lián)合腹腔鏡胃癌根治術(shù)治療老年進(jìn)展期胃癌患者的安全性和臨床效果。方法:將76例老年進(jìn)展期胃癌患者,根據(jù)圍手術(shù)期處理模式的不同分為兩組,即ERAS+LAG組(給予加速康復(fù)外科模式處理,共42例)和LAG組(給予傳統(tǒng)模式處理,共34例)。記錄本研究所需各項(xiàng)臨床指標(biāo),包括年齡、性別、腫瘤部位和大小、TNM分期和手術(shù)切除范圍;手術(shù)時(shí)間、術(shù)中出血量、淋巴結(jié)清掃數(shù)目;首次排氣時(shí)間、住院時(shí)間、住院費(fèi)用、并發(fā)癥發(fā)生情況;術(shù)后前三天疼痛評(píng)分(數(shù)字評(píng)分量表法);并隨訪4周。結(jié)果:1.兩組患者在年齡、性別、腫瘤大小和位置、TNM分期和手術(shù)切除范圍方面的差異無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。2.兩組患者在手術(shù)時(shí)間、術(shù)中出血量、淋巴結(jié)清掃數(shù)目方面的差別無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。3.ERAS+LAG組術(shù)后腸道功能恢復(fù)快于對(duì)照組[(65.50±9.17)h vs.(79.08±9.06)h,P0.05],住院時(shí)間短于對(duì)照組[(14.30±4.00)d vs.(18.08±4.08)d,P0.05],住院費(fèi)用低于對(duì)照組[(5.41±0.75)d vs.(6.80±0.69)d,P0.05];ERAS+LAG組術(shù)后鎮(zhèn)痛效果好(P0.05)。兩組患者術(shù)后并發(fā)癥發(fā)生率方面的差異無(wú)統(tǒng)計(jì)學(xué)意義(11.63%vs.12.73%,χ2=0.000,P=0.985)。結(jié)論:加速康復(fù)外科聯(lián)合腹腔鏡胃癌根治術(shù)治療老年進(jìn)展期胃癌安全、有效,且優(yōu)勢(shì)明顯。
[Abstract]:Objective: to investigate the safety and clinical effect of accelerated rehabilitation surgery combined with laparoscopic radical gastrectomy for elderly patients with advanced gastric cancer. Methods: 76 elderly patients with advanced gastric cancer were divided into two groups according to different perioperative management models: ERAS LAG group (42 cases treated by accelerated rehabilitation surgery) and LAG group (34 cases treated by traditional mode). To record the clinical parameters of the study, including age, sex, tumor location and size, TNM staging and surgical resection range; operative time, intraoperative bleeding volume, number of lymph nodes dissection, first exhaust time, hospitalization time, hospitalization cost, The incidence of complications, the pain score in the first three days after operation (digital score scale), and follow-up for 4 weeks. The result is 1: 1. There was no significant difference in age, sex, tumor size and location between the two groups in TNM staging and surgical resection range (all P 0.05. 2). The time of operation and the amount of blood lost during operation were observed in both groups. There was no significant difference in the number of lymph node dissection in P0.05).3.ERAS LAG group (the recovery of intestinal function in P0.05).3.ERAS LAG group was faster than that in control group [65.50 鹵9.17 h vs.(79.08 鹵9.06 h P 0.05], the hospitalization time was shorter than that in control group [14.30 鹵4.00 d vs.(18.08 鹵4.08 d P 0.05], and the cost of hospitalization was lower than that in control group (5.41 鹵0.75 d vs.(6.80 鹵0.69 d P 0.05). There was no significant difference in the incidence of postoperative complications between the two groups. Conclusion: accelerated rehabilitation surgery combined with laparoscopic radical gastrectomy is safe, effective and superior in the treatment of advanced gastric cancer in the elderly.
【學(xué)位授予單位】：吉林大學(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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