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目的:探讨采用快速康复外科(FTS)处理结肠癌手术患者的可行性。方法:40例结肠癌患者分为两组,每组20例,均行根治切除术。对照组予以常规处理;FTS组处理主要措施:详细术前教育;术前晚8点口服5%葡萄糖生理盐水1 000 mL,术晨6点静脉滴入10%葡萄糖液500 mL;全身麻醉复合硬膜外阻滞麻醉;不做不必要的大范围清除;术中保温;术后严格限制补液量;给予硬膜外镇痛;术后第1天停用抗生素并拔除胃肠减压管及导尿管、口服流质及下床活动;术后d2或d3拔除腹腔引流管等。比较两组术后口服固体食物时间、肠道功能、并发症及住院费用等情况。结果:与对照组相比,FTS组肠功能恢复时间缩短〔(46.6±7.3)hvs(73.4±6.9)h,P<0.05〕,术后进食固体食物较早〔(59.4±6.8)hvs(92.7±10.6)h,P<0.05〕,治疗费用减少约10.6%,并发症发生率差异无统计学意义(4/20vs5/20,P>0.05)。结论:结肠癌患者采用FTS措施安全可行,可促进患者康复,节省医疗资源。
Objective: To explore the feasibility of using rapid rehabilitation surgery (FTS) to treat colon cancer patients. Methods: Forty colon cancer patients were divided into two groups, 20 cases in each group. All patients underwent radical resection. The control group was given conventional treatment. The main measures of FTS group were: detailed preoperative education; 1 000 mL 5% dextrose normal saline at 8 o’clock in the evening and 500 mL 10% dextrose solution intravenously at 6 o’clock in the morning; Epidural anesthesia; do not do unnecessary large-scale removal; intraoperative insulation; strict restriction of fluid volume after surgery; to give epidural analgesia; 1 day after the withdrawal of antibiotics and removal of gastrointestinal decompression tube and guide Catheter, oral liquid and out of bed activity; d2 or d3 after removal of the abdominal drainage tube. The postoperative oral solid food time, intestinal function, complications and hospitalization costs were compared between the two groups. Results: Compared with the control group, the recovery time of intestinal function in FTS group was shorter than that in control group (46.6 ± 7.3 hrs vs 73.4 ± 6.9 h, P <0.05) ± 10.6) h, P <0.05〕. The cost of treatment was reduced by about 10.6%. There was no significant difference in the incidence of complications (4/20 vs 5/20, P> 0.05). Conclusion: FTS is safe and feasible in patients with colon cancer, which can promote the recovery of patients and save medical resources.