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目的探讨快速康复外科在直肠癌手术中的应用价值。方法符合入组条件的60例直肠癌患者随机均分为快速康复组(A组)和传统治疗组(B组)。A组快速康复外科措施包括:(1)术前进流质1d,口服泻剂,不灌肠;(2)术前4h一次性口服能量液体,例如糖水250ml;(3)术前不留置胃管和导尿管;(4)术后第1天进流质后,限制性补液,补液量2000-2500ml。比较术后第1天白细胞计数、术后首次排气时间、术后住院天数和并发症发生率等指标。结果与B组比较,A组术后第1天白细胞计数低[(10.50±1.56)×109/L vs.(13.04±2.53)×109/L](P<0.05),排气时间早[(2.5±0.6)d vs.(3.8±0.7)d](P<0.05),住院时间短[(9.1±2.9)d vs.(11.6±3.5)d](P<0.05),并发症发生率低(10.0%vs.30.0%)(P<0.05)。结论在直肠癌手术中合理应用快速康复外科措施可以促进患者肠道功能恢复,减少并发症和住院时间。
Objective To investigate the value of rapid rehabilitation surgery in rectal cancer surgery. Methods Sixty patients with rectal cancer, who met the criteria of admission, were randomly divided into fast-rehab group (group A) and traditional treatment group (group B). A group of rapid rehabilitation surgical measures include: (1) surgical preoperative liquid 1d, oral laxatives, no enema; (2) 4h preoperative oral energy liquid, such as sugar 250ml; (3) without preoperative gastric tube and Catheterization; (4) after the first day into the liquid, limited rehydration, fluid volume 2000-2500ml. The white blood cell count, the first postoperative exhaust time, the length of postoperative hospital stay and the incidence of complications were compared between the two groups. Results Compared with group B, the white blood cell count of group A was lower on the first day after operation ([10.50 ± 1.56] × 109 / L vs. (13.04 ± 2.53) × 109 / L] 2.5 ± 0.6 d vs. 3.8 ± 0.7 d] (P <0.05), short hospital stay (9.1 ± 2.9 d vs. (11.6 ± 3.5) d] (P <0.05), and low complication rates (10.0% vs. 30.0%) (P <0.05). Conclusion The rational application of rapid rehabilitation of surgical procedures in rectal cancer surgery can promote intestinal function recovery, reduce complications and hospitalization time.