冯敏　唐成武

[摘要] 目的 探讨加速康复外科措施在结肠癌根治术中的应用价值。 方法 2015年8月～2017年8月间124例结肠癌患者在本院行手术治疗，其中61例患者接受加速康复外科治疗（ERAS组），其余 63例患者接受常规治疗（对照组）。比較两组患者术后肠功能恢复时间、排便时间、进食半流质时间、术后住院时间、总住院时间、住院费用和术后并发症等。 结果 ERAS组术后肠功能恢复时间（32.45±5.24 vs 57.32±5.24，P=0.0000）h，排便时间（68.24±9.65 vs 94.25±11.41，P=0.0000）h，进食半流质时间（3.74±0.92 vs 5.23±1.12，P=0.0000）d，术后住院时间（12.14±2.74 vs 15.24±3.47，P=0.0000）d，总住院时间（15.47±2.78 vs 19.34±3.24，P=0.0000）d，住院费用（48527.85±304.21 vs 52342.21±345.22，P=0.0000）元，均较对照组明显减少。ERAS组肺部感染（3/61 vs 12/63，P=0.0159）、尿潴留（4/61 vs 13/63，P=0.0227）、泌尿系感染（3/61 vs 11/63，P=0.0102）发生率明显低于对照组。两组深静脉血栓（1/61 vs 3/63，P=0.3252）、切口感染（9/61 vs 12/63，P=0.5239）、吻合口出血（3/61 vs 4/63，P=0.7299）、吻合口漏（2/61 vs 3/63，P=0.6747）发生率无明显差异。 结论 加速康复外科措施能促进结肠癌患者术后恢复，减少并发症的发生。

[关键词] 结肠癌；加速康复外科；并发症；康复；围手术期

[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701（2018）20-0064-04

Pathogen distribution and antimicrobial resistance in neurological intensive care unit

FENG Min TANG Chengwu

Department of Surgery， First Affiliated People's Hospital of Huzhou University， Huzhou 313000， China

[Abstract] Objective To investigate the value of applying enhanced recovery after surgery （ERAS） in patients with colon carcinoma treated with radical surgery. Methods 124 patients with colon carcinoma in our hospital from August， 2015 to August， 2017 were through radical surgery. Out of them， 61 received ERAS treatment （ERAS group） and 61 received conventional treatment（control group）. The time of restored enteric function， defecation， semi-liquid diet consumed， hospital stay after surgery and overall hospital stay as well as the hospitalization expenses and complications after surgery were compared in two groups. Results There were significant decreases in the time of restored enteric function （32.45±5.24 vs 57.32±5.24， P=0.0000）h， defecation（68.24±9.65 vs 94.25±11.41， P=0.0000）h， semi-liquid diet consumed （3.74±0.92 vs 5.23±1.12， P=0.0000）d， hospital stay after surgery （12.14±2.74 vs 15.24±3.47， P=0.0000）d and overall hospital stay（15.47±2.78 vs 19.34±3.24， P=0.0000）d as well as the hospitalization expenses（48527.85±304.21 vs 52342.21±345.22， P=0.0000） RMB in ERAS group than those in control group. The incidence of pulmonary infection（3/61 vs 12/63， P=0.0159）， retention of urine（4/61 vs 13/63， P=0.0227） and urinary tract infection（3/61 vs 11/63， P=0.0102） in ERAS group was significantly lower than control group. There was no significant difference in the incidence of deep vein thrombosis（1/61 vs 3/63， P=0.3252）， incision infection （9/61 vs 12/63， P=0.5239）， anastomotic bleeding（3/61 vs 4/63， P=0.7299） and anastomotic leaking（2/61 vs 3/63， P=0.6747） between two groups. Conclusion ERAS could improve the recovery of patients with colon carcinoma treated with radical surgery and decrease the incidence of complications.

[Key words] Colon carcinoma； Enhanced recovery after surgery； Complication； Recovery； Peri-operative period

结肠癌是我国常见的消化道恶性肿瘤，发病率居我国恶性肿瘤的第四位，并有逐渐上升的趋势[1]。目前针对结肠癌最有效的治疗手段是根治切除。结肠肿瘤传统的围术期处理方法患者常较痛苦，患者承受的生理及心理的创伤应激巨大，术后恢复时间长。加速康复外科（enhanced recovery after surgery，ERAS）指通过各种手术前后的准备措施，来降低手术引起的创伤及应激反应，促进患者恢复，在临床实践中被到越来越多的应用。本研究将ERAS应用于结肠癌手术患者，探讨其对患者术后恢复及并发症的影响。

1资料与方法

1.1 病例选择

回顾性研究 2015年8月～2017年8月间在本院行手术治疗的124例结肠癌患者，根据治疗方法不同分为ERAS组和对照组。……