中华普通外科学文献（电子版）
中華普通外科學文獻（電子版）
중화보통외과학문헌（전자판）
CHINESE JOURNAL OF GENERAL SURGERY(ELECTRONIC VERSION)
2014年
3期
200-203
,共4页
龚龙波%吕孝鹏%孟良%谢志远
龔龍波%呂孝鵬%孟良%謝誌遠
공룡파%려효붕%맹량%사지원
腹腔镜结直肠手术%经口进食%快速康复
腹腔鏡結直腸手術%經口進食%快速康複
복강경결직장수술%경구진식%쾌속강복
Laparoscopic colorectal surgery%Oral feeding%Fast recovery
目的：观察腹腔镜辅助结直肠癌术后早期经口进食的安全性及对临床结局的影响。方法选择2012年3月至2013年3月间东南大学医学院附属徐州医院胃肠外科收治的接受腹腔镜辅助结直肠癌手术治疗的患者120例，随机分为早期进食组及传统进食组，各60例，比较两组患者术后恢复情况、营养状况及并发症发生率。结果103例完成试验，其中早期进食组58例，传统进食组45例，早期进食组与传统进食组术后首次排气时间[（51.8±11.0）h vs（64.2±12.3）h， t=-5.39，P=0.000]、排便时间[（65.9±8.5）h vs（73.2±13.7）h，t=-2.94，P=0.004]、住院费用[（42.88±5.46）千元vs（46.25±7.73）千元，t=-2.35，P=0.021]相比，差异均有统计学意义；术后第7天早期进食组的白蛋白及前白蛋白水平均高于传统进食组，差异有统计学意义（P<0.05），两组患者住院时间、吻合口瘘、肺部感染、切口感染、胃潴留及腹泻等并发症发生率差异均无统计学意义，患者早期经口进食耐受率为86.21%（50/58）。结论腹腔镜辅助结直肠癌术后早期经口进食安全有效，能促进肠道功能恢复、改善患者营养状况。
目的：觀察腹腔鏡輔助結直腸癌術後早期經口進食的安全性及對臨床結跼的影響。方法選擇2012年3月至2013年3月間東南大學醫學院附屬徐州醫院胃腸外科收治的接受腹腔鏡輔助結直腸癌手術治療的患者120例，隨機分為早期進食組及傳統進食組，各60例，比較兩組患者術後恢複情況、營養狀況及併髮癥髮生率。結果103例完成試驗，其中早期進食組58例，傳統進食組45例，早期進食組與傳統進食組術後首次排氣時間[（51.8±11.0）h vs（64.2±12.3）h， t=-5.39，P=0.000]、排便時間[（65.9±8.5）h vs（73.2±13.7）h，t=-2.94，P=0.004]、住院費用[（42.88±5.46）韆元vs（46.25±7.73）韆元，t=-2.35，P=0.021]相比，差異均有統計學意義；術後第7天早期進食組的白蛋白及前白蛋白水平均高于傳統進食組，差異有統計學意義（P<0.05），兩組患者住院時間、吻閤口瘺、肺部感染、切口感染、胃潴留及腹瀉等併髮癥髮生率差異均無統計學意義，患者早期經口進食耐受率為86.21%（50/58）。結論腹腔鏡輔助結直腸癌術後早期經口進食安全有效，能促進腸道功能恢複、改善患者營養狀況。
목적：관찰복강경보조결직장암술후조기경구진식적안전성급대림상결국적영향。방법선택2012년3월지2013년3월간동남대학의학원부속서주의원위장외과수치적접수복강경보조결직장암수술치료적환자120례，수궤분위조기진식조급전통진식조，각60례，비교량조환자술후회복정황、영양상황급병발증발생솔。결과103례완성시험，기중조기진식조58례，전통진식조45례，조기진식조여전통진식조술후수차배기시간[（51.8±11.0）h vs（64.2±12.3）h， t=-5.39，P=0.000]、배편시간[（65.9±8.5）h vs（73.2±13.7）h，t=-2.94，P=0.004]、주원비용[（42.88±5.46）천원vs（46.25±7.73）천원，t=-2.35，P=0.021]상비，차이균유통계학의의；술후제7천조기진식조적백단백급전백단백수평균고우전통진식조，차이유통계학의의（P<0.05），량조환자주원시간、문합구루、폐부감염、절구감염、위저류급복사등병발증발생솔차이균무통계학의의，환자조기경구진식내수솔위86.21%（50/58）。결론복강경보조결직장암술후조기경구진식안전유효，능촉진장도공능회복、개선환자영양상황。
Objective To investigate the safety and clinical outcomes of early oral feeding after laparoscopic surgery of colorectal cancer. Methods A randomized controlled clinical trial was conducted from March 2012 to March 2013 in the Department of Gastrointestinal Surgery, Xuzhou Hospital, Medical College of Southeast University. A total of 120 patients with colorectal cancer undergoing laparoscopic surgery were randomly divided into early oral feeding group (60 cases) and conventional oral feeding group (60 cases). Clinical parameters, markers of nutrition and postoperative complications were evaluated in both groups postoperatively. Results One hundred and three patients eventually completed the study, including 58 cases in early oral feeding group and 45 cases in conventional oral feeding group. Compared to the conventional oral feeding group, the first postoperative time of flatus was significantly shorter in the early oral feeding group [(51.8±11.0) h vs (64.2±12.3) h, t=-5.39, P=0.000], as were the first passage of stool [(65.9±8.5) h vs (73.2±13.7) h, t=-2.94, P=0.004], and medical cost [(42 880±5 460) RMB vs (46 250±7 730) RMB, t=-2.35,P=0.021]. The levels of albumin and prealbumin were significant higher in the early oral feeding group as compared to the conventional oral feeding group on the 7th postoperative day (P<0.05). The differences of length of hospital stay, anastomotic leakage, pulmonary infection, wound infection, gastric retention and diarrhea were not statistically significant between the two groups. The rate of early oral feeding reached as much as 86.21%(50/58).Conclusions Early oral feeding after laparoscopic surgery of colorectal cancer is safe and effective. It can promote the intestinal function recovery and improve the nutritional status.
