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目的探讨损伤控制和加速康复外科理念在胃癌手术中的临床应用价值。方法选择2011年2月至2012年4月在郸城县人民医院普外科住院手术治疗的胃癌患者40例作为干预组,采用损伤控制和加速康复外科技术方案;对照组30例,采用传统围术期治疗方案及常规手术模式,观察并比较两组患者术后肛门排气、排便时间,术后并发症(切口感染、吻合口漏及肠梗阻),术后第3天C-反应蛋白水平和术后住院天数。结果与对照组比较,观察组肛门排气、排便时间及住院天数明显缩短,术后第3天C-反应蛋白水平减低,两者比较差异有统计意义(P<0.05);并发症方面,观察组3例出现切口感染,对照组5例出现切口感染,两者比较差异有统计学意义(P<0.05)。8例患者均进行开放切口,通畅引流,清洁换药后愈合。结论应用损伤控制和加速康复外科理念治疗胃癌患者能够减少并发症的发生,减低应激反应,加快术后恢复,值得临床推广应用。
Objective To investigate the clinical value of wound control and accelerated rehabilitation surgery in gastric cancer surgery. Methods From February 2011 to April 2012, 40 patients with gastric cancer surgically treated in general surgery department of Dancheng People’s Hospital were selected as the intervention group, and the control and accelerated surgical techniques were used. In the control group, 30 patients were treated by traditional perioperative Duration of treatment, postoperative complications (incision infection, anastomotic leakage and intestinal obstruction), C-reactive protein level on the third postoperative day and postoperative complications were compared between the two groups Postoperative hospital days. Results Compared with the control group, the anus exhaust, defecation time and days of hospitalization in the observation group were significantly shortened, and the C-reactive protein level was decreased on the third day after the operation. There was significant difference between the two groups (P <0.05). Complications There were 3 cases of incision infection in the group and 5 cases of incision infection in the control group, the difference was statistically significant (P <0.05). All 8 patients underwent open incision, unobstructed drainage, healing after dressing change. Conclusion The application of injury control and accelerated rehabilitation surgical treatment of gastric cancer patients can reduce the incidence of complications, reduce stress response and speed up postoperative recovery, which is worthy of clinical application.