李丽 冯海洋 陈秀云 傅萍萍

[摘要] 目的 探討快速康复模式在腹腔镜结直肠癌患者围手术期的效果。 方法 选取2018年5月～2019年5月在我院结直肠外科行腹腔镜手术的结直肠癌患者96例，按照随机数字表法分为实验组和对照组，各48例，实验组患者在围手术期间给予快速康复模式进行干预，对照组患者在围手术期间给予常规干预。比较两组患者的手术完成情况，如麻醉时间、手术时间、术中出血量;及术后恢复情况，如术后排气时间、下床活动时间、住院时间。两组患者均在术后6 h、12 h、24 h、48 h、72 h采用疼痛数字评分法（NRS）进行疼痛评分，记录两组患者的术后并发症发生率。 结果 两组患者手术麻醉时间、手术时间、术中出血量比较差异无统计学意义（P>0.05）;实验组患者经快速康复模式干预后术后排气时间、下床活动时间及住院时间均较对照组明显缩短（P<0.01）;实验组患者经快速康复模式干预后在术后6 h、12 h、24 h、48 h时间点NRS评分均明显低于对照组（P<0.05）;实验组经快速康复模式干预后术后并发症总发生率为10.43%，明显低于对照组的27.09%（P<0.05）。 结论 快速康复模式应用于腹腔镜结直肠癌患者围手术期可明显促进患者术后恢复，减少术后并发症的发生，使有限的医疗资源得以充分利用，可在临床推广使用。

[关键词] 快速康复模式;腹腔镜;结直肠癌;围手术期;临床效果

[中图分类号] R735.3          [文献标识码] B          [文章编号] 1673-9701（2020）16-0088-04

Observation of the effect of rapid rehabilitation model on perioperative period of patients with laparoscopic colorectal cancer

LI Li   FENG Haiyang   CHEN Xiuyun   FU Pingping

Department of Colorectal Surgery， Cancer Hospital Affiliated to the University of Chinese Academy of Sciences， Hangzhou   310000，China

[Abstract] Objective To explore the effect of rapid rehabilitation model on perioperative period of laparoscopic colorectal cancer patients. Methods 96 patients with colorectal cancer who underwent laparoscopic surgery in the department of colorectal surgery in our hospital from May 2018 to May 2019 were divided into the experimental group（n=48） and the control group（n=48）， according to the random number table method. Patients in the experimental group underwent rapid rehabilitation model for intervention during the perioperative period. Patients in the control group were given routine intervention during the perioperative period. The operation completion status such as anesthesia time， operation time and intraoperative blood loss， and postoperative recovery conditions such as postoperative exhaust time， time to get out of bed， hospitalization time between the two groups were compared. The pain scores in both groups were scored using the NRS（Numerical Pain Scoring Method） at 6 h， 12 h， 24 h， 48 h， and 72 h. The incidence of postoperative complications in the two groups was recorded. Results There was no significant difference in the time of anesthesia， operation time， and intraoperative blood loss between the two groups（P>0.05）. After the rapid rehabilitation mode intervention， the patients in the experimental group had significantly shorter postoperative exhaust time， time to get out of bed， and hospital stay than the control group（P<0.01）. The NRS scores of the experimental group were significantly lower than that of the control group at the postoperative 6 h， 12 h， 24 h， and 48 h after rapid rehabilitation intervention mode（P<0.05）. The total incidence of postoperative complications in the experimental group after rapid rehabilitation model intervention was 10.41%， which was significantly lower than that of the control group（27.09%）（P<0.05）. Conclusion The rapid rehabilitation model applied during the perioperative period in laparoscopic colorectal cancer patients can significantly promote the postoperative recovery of patients， reduce the occurrence of postoperative complications， make the limited medical resources be fully utilized， and can be used in clinical promotion.

[Key words] Rapid rehabilitation model; Laparoscopy; Colorectal cancer; Perioperative period; Clinical effect

结直肠癌又称为大肠癌，包括结肠癌和直肠癌，是消化系统常见的恶性肿瘤。患者早期无明显症状，随着肿瘤的逐渐发展可表现为腹痛、大便习惯改变、便血，并伴有贫血、发热等全身症状，患者根据发病部位的不同而表现出不同的临床症状[1-2]。近年来随着人类寿命的延长，结直肠癌发病率逐年上升，且死亡率仅次于胃癌和肺癌，对人们的生命健康带来严重威胁[1]。目前结直肠癌的治疗主要以根治性手术为主，随着医学科技的不断发展，腹腔镜手术已成为结直肠癌的主要治疗方式，其具有创伤小、恢复快、出血量低等优点，已在临床得到广泛应用[3]。快速……