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快速康复方案与食管癌术后常规治疗的对比:一项回顾性对照队列研究。

Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study.

机构信息

Department of Thoracic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.

出版信息

Support Care Cancer. 2013 Mar;21(3):707-14. doi: 10.1007/s00520-012-1570-0. Epub 2012 Aug 30.

Abstract

PURPOSE

The purpose of this article is to evaluate fast-track rehabilitation program and conventional care after esophagectomy using a retrospective controlled cohort study in esophageal cancer patients.

METHODS

Fifty-five patients underwent fast-track rehabilitation program and 57 patients underwent conventional care after esophagectomy. Fast-track rehabilitation program was performed to patients who have early movement, epidural analgesia control, fluid infusion volume control and enteral nutrition for early discharge. The other 57 patients underwent conventional care after esophagectomy. The average of hospital stay and complications were calculated in the patients between the two groups.

RESULTS

The median length of hospital stay in the patients was significantly shorter after fast-track rehabilitation program than after conventional care (7.7 vs 14.8 day, P < 0.01). The percentage of patients who developed complications was significantly lower 30 day after fast-track rehabilitation program than after conventional care (29.1 vs 47.4%, P < 0.05). 87.3% in patients of the fast-track rehabilitation program group and 54.4% in those of the conventional care group reported excellent to very good satisfaction with their pain control (P = 0.000).

CONCLUSIONS

The fast-track rehabilitation program results in fewer complications, less postoperative pain, a reduction in the hospital length of stay, and quicker return to work and normal activities after esophagectomy.

摘要

目的

本研究旨在通过回顾性对照队列研究,评估食管癌患者术后快速康复方案与常规护理的效果。

方法

55 例患者接受快速康复方案,57 例患者接受常规护理。快速康复方案针对术后早期活动、硬膜外镇痛控制、输液量控制和早期肠内营养的患者实施。其余 57 例患者接受常规护理。计算两组患者的平均住院时间和并发症发生率。

结果

快速康复方案组患者的住院时间中位数明显短于常规护理组(7.7 天 vs 14.8 天,P < 0.01)。快速康复方案组患者术后 30 天并发症发生率明显低于常规护理组(29.1% vs 47.4%,P < 0.05)。快速康复方案组患者中有 87.3%报告对疼痛控制非常满意或满意,常规护理组患者中有 54.4%报告非常满意或满意(P = 0.000)。

结论

快速康复方案可减少并发症、减轻术后疼痛、缩短住院时间,并使患者更快地恢复工作和正常活动。

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