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加速康复外科在老年胃癌患者中的应用。

Application of ERAS in older patients with gastric cancer.

机构信息

Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China.

出版信息

Medicine (Baltimore). 2024 May 31;103(22):e38409. doi: 10.1097/MD.0000000000038409.

Abstract

BACKGROUND

The purpose of this study was to investigate the effectiveness and feasibility of enhanced recovery after surgery (ERAS) in older gastric cancer (GC) patients by observing the changes in postoperative intestinal function recovery, nutritional indicators, and inflammatory markers following the surgery.

METHODS

A total of 61 older GC patients who underwent laparoscopic radical gastrectomy were selected as the subjects of this study. They were divided into an ERAS group (n = 28) and a conventional control group (n = 33) based on the different management modes during the perioperative period. General data, inflammatory response indicators, nutritional indicators, and perioperative indicators of the 2 groups were collected and compared. The changes in relevant indicators were analyzed, and the underlying reasons for these changes were explored.

RESULTS

There were no significant differences in general data and preoperative indicators between the 2 groups (P > .05). In the ERAS group, the inflammatory markers decreased more rapidly, and the nutritional indicators recovered more quickly after surgery. The differences between the 2 groups were statistically significant on the 5th and 7th postoperative days (P < .05). The ERAS group had significantly shorter postoperative hospital stay (10.07 ± 1.41 vs 13.04 ± 3.81), shorter time to first flatus (3.70 ± 0.72 vs 4.18 ± 1.17), shorter drainage tube retention time (8.96 ± 1.53 vs 10.93 ± 3.36), and shorter nasogastric tube retention time (3.36 ± 1.72 vs 6.14 ± 3.99) compared to the control group (P < .05).

CONCLUSION

The application of the ERAS program in older GC patients is effective and feasible, and significantly contributes to faster postoperative recovery in older patients.

摘要

背景

本研究旨在观察术后肠道功能恢复、营养指标和炎症指标的变化,探讨加速康复外科(ERAS)在老年胃癌(GC)患者中的有效性和可行性。

方法

选择 61 例行腹腔镜根治性胃切除术的老年 GC 患者为研究对象,根据围手术期管理模式的不同分为 ERAS 组(n=28)和常规对照组(n=33)。收集并比较两组的一般资料、炎症反应指标、营养指标和围手术期指标,分析相关指标的变化,并探讨其变化的原因。

结果

两组一般资料和术前指标比较差异无统计学意义(P>0.05)。ERAS 组术后炎症指标下降更快,营养指标恢复更快,术后第 5、7 天两组比较差异有统计学意义(P<0.05)。ERAS 组术后住院时间(10.07±1.41 vs 13.04±3.81)、首次排气时间(3.70±0.72 vs 4.18±1.17)、引流管留置时间(8.96±1.53 vs 10.93±3.36)、胃管留置时间(3.36±1.72 vs 6.14±3.99)均明显短于对照组(P<0.05)。

结论

ERAS 方案在老年 GC 患者中的应用是有效且可行的,可显著促进老年患者术后的快速恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d479/11142792/93c306cfb0f3/medi-103-e38409-g001.jpg

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