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目的探讨医生的专业化程度对直肠癌根治性切除术质量的影响。方法纳入2007年7月-2009年12月收治且确诊为直肠癌的手术患者共679例,分为专业组(470例)和非专业组(209例),收集患者年龄、体质量指数(BMI)、肿瘤TNM分期、手术持续时间、术中出血量、术后胃肠功能恢复时间、术后并发症等围手术期指标,进行相关统计学分析。结果两组患者手术持续时间相当(P=0.322),但在专业组中患者术中出血量较非专业组少(P=0.008)。专业组患者术后拔除胃管时间(P=0.000)、拔除引流管时间(P=0.000)、首次进流质食物时间(P=0.002)、首次排便时间(P=0.007)和下床活动时间(P=0.001)均较非专业组提前,术后住院时间(P=0.152)与住院总时间(P=0.983)两组差异无统计学意义,且专业组术后并发症总发生率较低(P<0.05)。结论医生的专业化程度对直肠癌根治术患者围手术期的管理有显著影响,专业化程度高的直肠癌外科医生可为患者带来更好的手术效果。
Objective To explore the influence of doctors’ specialization on the quality of radical resection of rectal cancer. Methods A total of 679 surgical patients admitted to our hospital from July 2007 to December 2009 were diagnosed as rectal cancer. The patients were divided into professional group (470 cases) and non-professional group (209 cases). The age, body mass index (BMI ), Tumor TNM stage, operation duration, intraoperative blood loss, postoperative gastrointestinal function recovery time, postoperative complications and other perioperative indicators, the relevant statistical analysis. Results The duration of operation was similar in both groups (P = 0.322), but less bleeding in the professional group than in the nonprofessional group (P = 0.008). The patients in the professional group had significantly shorter time of gastric tube removal (P = 0.000), drainage tube time (P = 0.000), time to first intake of liquid food (P = 0.002), first defecation time (P = 0.007) (P = 0.001) compared with the non-professional group, there was no significant difference between the two groups in postoperative hospital stay (P = 0.152) and total hospitalization time (P = 0.983), and the total incidence of postoperative complications in the professional group was lower P <0.05). Conclusion The doctor’s specialization has a significant impact on the perioperative management of patients undergoing radical resection of rectal cancer. A highly specialized rectal surgeon can bring better surgical results to patients.