中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
10期
870-874
,共5页
杨东杰%何伟玲%张晟%陈华云%黄文起%蔡世荣%陈创奇%马晋平%张常华%何裕隆%詹文华
楊東傑%何偉玲%張晟%陳華雲%黃文起%蔡世榮%陳創奇%馬晉平%張常華%何裕隆%詹文華
양동걸%하위령%장성%진화운%황문기%채세영%진창기%마진평%장상화%하유륭%첨문화
结直肠癌%康复%胰岛素抗药性%随机对照试验
結直腸癌%康複%胰島素抗藥性%隨機對照試驗
결직장암%강복%이도소항약성%수궤대조시험
Colorectal neoplasms%Rehabilitation%Insulin resistance%Randomized controlled trial
目的 在改善患者临床结局的前提下,探讨快速康复外科对结直肠癌限期手术患者术后胰岛素敏感性的影响.方法 2008年5-12月在中山大学附属第一医院就诊的70例拟接受开放限期手术的结直肠癌患者随机分为快速康复组和传统治疗组,每组35例,分别接受快速康复治疗及传统治疗,评价2组患者的临床指标、应激指标及胰岛素敏感性.结果 共62例患者完成试验,其中快速康复组32例,传统治疗组30例.相对于传统治疗组,快速康复组患者术后胰岛素敏感性恢复快(术后第7天97％±9％,t =2.552,P =0.016),术后住院时间短(中位住院天数6d,Z=4.360,P =0.000),肠道功能恢复快(中位首次排气时间2d,Z=3.976,P =0.000),感染性并发症发生率低(2/32,p=0.040).结论 快速康复外科加速了结直肠癌限期手术患者术后胰岛素敏感性及术后肠道功能的恢复,降低了术后感染性并发症的发生率,缩短了术后住院时间.
目的 在改善患者臨床結跼的前提下,探討快速康複外科對結直腸癌限期手術患者術後胰島素敏感性的影響.方法 2008年5-12月在中山大學附屬第一醫院就診的70例擬接受開放限期手術的結直腸癌患者隨機分為快速康複組和傳統治療組,每組35例,分彆接受快速康複治療及傳統治療,評價2組患者的臨床指標、應激指標及胰島素敏感性.結果 共62例患者完成試驗,其中快速康複組32例,傳統治療組30例.相對于傳統治療組,快速康複組患者術後胰島素敏感性恢複快(術後第7天97％±9％,t =2.552,P =0.016),術後住院時間短(中位住院天數6d,Z=4.360,P =0.000),腸道功能恢複快(中位首次排氣時間2d,Z=3.976,P =0.000),感染性併髮癥髮生率低(2/32,p=0.040).結論 快速康複外科加速瞭結直腸癌限期手術患者術後胰島素敏感性及術後腸道功能的恢複,降低瞭術後感染性併髮癥的髮生率,縮短瞭術後住院時間.
목적 재개선환자림상결국적전제하,탐토쾌속강복외과대결직장암한기수술환자술후이도소민감성적영향.방법 2008년5-12월재중산대학부속제일의원취진적70례의접수개방한기수술적결직장암환자수궤분위쾌속강복조화전통치료조,매조35례,분별접수쾌속강복치료급전통치료,평개2조환자적림상지표、응격지표급이도소민감성.결과 공62례환자완성시험,기중쾌속강복조32례,전통치료조30례.상대우전통치료조,쾌속강복조환자술후이도소민감성회복쾌(술후제7천97％±9％,t =2.552,P =0.016),술후주원시간단(중위주원천수6d,Z=4.360,P =0.000),장도공능회복쾌(중위수차배기시간2d,Z=3.976,P =0.000),감염성병발증발생솔저(2/32,p=0.040).결론 쾌속강복외과가속료결직장암한기수술환자술후이도소민감성급술후장도공능적회복,강저료술후감염성병발증적발생솔,축단료술후주원시간.
Objective To investigate the effects of fast track surgery on postoperative insulin sensitivity on the basis of clinical benefits in patients undergoing elective open colorectal resection.Methods During May 2008 to December 2008, Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups:a fast track group (35 cases) and a conventional care group (35 cases).All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters,stress markers and insulin sensitivity were evaluated in both groups.Results The 62 patients finally completed the study,32 cases in the fast-track group and 30 cases in the conventional care group. The speed of recovery of postoperative insulin sensitivity on 7 days postoperative in the fast-track group (97％ ± 9％ ) was significantly faster than the conventional care group (88.5％ ±9.0％,t =2.552,P =0.016).The hospitalization days in the fast-track group was 6 days ( M50 ),and it was significantly shorter than the conventional care group ( ( 11.7 ± 3.8 ) days,Z =4.360,P =0.000).The time of recovery of bowel function were faster in the fast-track group ( time to pass flatus was 2 days (M50) ) than the conventional care group (4 days,Z =3.976,P =0.000).The Infectious complication rate in the fast-track group ( 2/32 ) is lower than the other group ( 8/30,P =0.040 ).Conclusion Fast track surgery accelerates recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a lower rate of postoperative infectious complications and a shorter length of postoperative hospital stay.
