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目的探讨快速流程完成率对结直肠癌根治术术后管理的影响。方法回顾性分析2010年2～5月期间四川大学华西医院胃肠外科中心结直肠外科专业组收治的100例结直肠癌患者(2010年组)及2008年2～5月期间收治的76例结直肠癌患者(2008年组)的临床资料,比较2组患者术后康复情况、并发症发生情况及快速流程完成情况。结果快速流程各主要环节中,2010年组液体限制、早期下床活动、早期经口进食、胃管管理和引流管管理完成率均高于2008年组,其差异有统计学意义(P<0.05);而2008年组尿管管理的完成率则明显高于2010年组,其差异也有统计学意义(P<0.05)。术后康复方面,2010年组术后首次排气时间〔(3.86±1.05)d比(4.28±1.22)d〕明显早于2008年组,其差异有统计学意义(P<0.05),而2组术后住院时间之间的差异没有统计学意义(P>0.05)。同时,2组患者并发症总发生率及各项并发症的发生率之间的差异均无统计学意义(P>0.05)。结论随着对快速流程理念接受程度的增高,快速流程各环节的完成率明显提高,越来越多的环节成为常规管理方式,患者早期康复也更好,但发挥快速流程最大优势尚需加强多学科合作及克服本土化的困难。
Objective To investigate the effect of rapid procedure completion rate on postoperative management of colorectal cancer. Methods A retrospective analysis of 100 colorectal cancer patients (2010 group) admitted to the Department of Colorectal Surgery at the Center of Gastrointestinal Surgery, West China Hospital of Sichuan University during the period from February to May 2010 and 76 cases during the period from February to May 2008 The clinical data of patients with rectal cancer (group of 2008) compared postoperative rehabilitation, complications, and completion of rapid procedures between the two groups of patients. Results In the main processes of the rapid flow, the liquid confinement, early ambulation, early oral food intake, gastric tube management, and drainage tube management completion rate in the 2010 group were all higher than those in the 2008 group. The difference was statistically significant (P<0.05). ); In 2008, the completion rate of urinary catheter management was significantly higher than that of the 2010 group, and the difference was statistically significant (P<0.05). In terms of postoperative rehabilitation, the first postoperative evacuation time in the 2010 group was ((3.86±1.05) d vs. (4.28±1.22) d) significantly earlier than that of the 2008 group. The difference was statistically significant (P<0.05). The difference in postoperative hospital stay was not statistically significant (P>0.05). At the same time, there was no significant difference in the total incidence of complications and the incidence of complications between the two groups (P>0.05). Conclusion With the increase in the acceptance of rapid process concepts, the completion rate of each step of the rapid process has been significantly improved, more and more links have become routine management methods, and patients’ early rehabilitation is also better, but the maximum advantage of rapid process needs to be strengthened. Subject cooperation and overcome localization difficulties.