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目的探讨快速康复外科理念在食管癌手术中的应用。方法自2008年7月—2010年7月对204例食管癌患者进行外科手术治疗,按病案号单双数分为2组,单数组96位患者接受快速康复外科新理念治疗-术后第1d开始肠内营养(FTS组),双数组108位患者采用传统方法治疗(对照组)。比较2组术后首次排气、排便时间,肺部感染、吻合口瘘等严重并发症发生率。结果 FTS组:术后首次排气时间28~92h,中位数52h;首次排便时间32~106h,中位数70h;肺部感染发生率4.2%,吻合口瘘发生率1.1%。对照组:术后首次排气时间45~132h,中位数84h,排便时间75~154h,中位数92h;肺部感染发生率16.7%;吻合口瘘发生率1.9%。对照组和FTS组患者术后首次排气和排便时间、肺部并发症发生率差异均有统计学意义,吻合口瘘发生率两组间差异无统计学意义。结论 FTS新理念治疗可以有效促进食管癌术后胃肠道功能的恢复,缩短禁食时间,减少肺部感染发生率,并未增加吻合口瘘发生率。
Objective To explore the concept of rapid rehabilitation surgery in esophageal cancer surgery. Methods Twenty-four patients with esophageal cancer underwent surgical treatment from July 2008 to July 2010. Patients were divided into two groups according to the number of single case and double case. A single group of 96 patients underwent a new concept of rapid rehabilitation surgery - Enteral nutrition (FTS group) was started, and 108 patients in the double-array group were treated by conventional methods (control group). The incidences of serious complications such as first excretion, defecation time, lung infection and anastomotic leakage were compared between the two groups. Results The first postoperative exhaust time was 28-92 hours, with a median of 52 hours. The first defecation time was 32-106 hours with a median of 70 hours. The incidence of pulmonary infection was 4.2% and the incidence of anastomotic fistula was 1.1%. In the control group, the time of first extubation was 45- 132h, the median time was 84h, the defecation time was 75-154h, the median was 92h. The incidence of pulmonary infection was 16.7%. The incidence of anastomotic fistula was 1.9%. The first postoperative exhaust and defecation time, the incidence of pulmonary complications in the control group and the FTS group were statistically significant, the incidence of anastomotic leakage was no significant difference between the two groups. Conclusion The new concept of treatment of FTS can effectively promote the recovery of gastrointestinal function after esophageal cancer surgery, shorten the fasting time and reduce the incidence of pulmonary infection, did not increase the incidence of anastomotic leakage.