加速康复外科在下咽癌手术治疗中的应用研究

来源 :中华耳鼻咽喉头颈外科杂志 | 被引量 : 0次 | 上传用户:wiqjhag
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:探讨加速康复外科(enhanced recovery after surgery,ERAS)在下咽癌外科治疗中的临床应用价值。方法:回顾性分析山东大学齐鲁医院2015年1月至2019年1月期间收治并进行手术的168例原发于梨状窝的下咽癌患者的病例资料,其中男164例,女4例,年龄42~84岁。根据围手术期处理方式不同,分为ERAS处理组(64例)和传统处理组(104例),运用n t检验、χ2检验或Fisher精确检验等统计学方法,比较2组患者术中及术后恢复情况,包括手术时长、术后营养状态、并发症发生率、术后住院时间等指标。n 结果:与传统处理组相比,ERAS处理组患者的手术时长显著缩短,差异有统计学意义[(166.8±58.2)min比(183.3±39.9)min,n t=-2.72,n P=0.031],术后血清白蛋白水平[(38.3±4.2)μmol/L比(36.6±3.3)μmol/L]及体重[(65.4±9.4)kg比(62.1±9.4)kg]均明显提升,差异有统计学意义(n t值为2.73、2.22,n P值均<0.05),颈部切口皮下感染[7.8%(5/64)比20.2%(21/104)]及重症肺炎的发生率[4.7%(3/64)比15.4%(16/104)]显著下降,差异有统计学意义(n χ2值分别为4.64、4.52,n P值均<0.05),术后住院时间明显缩短,差异有统计学意义[(16.5±3.9)d比(18.2±4.3)d,n t=-2.65,n P<0.05]。n 结论:在下咽癌手术治疗中应用ERAS能够通过缩短手术时间以减轻患者手术应激,改善患者术后营养状态,缩短住院时间并减少并发症的发生,促进患者快速康复。“,”Objective:To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) in the clinical management of hypopharyngeal squamous cell carcinoma (HSCC).Methods:In this retrospective study, a total of 168 patients with pyriform sinus carcinoma in Qilu Hospital of Shandong University from January 2015 to January 2019 were divided into two groups, based on the different perioperative interventions that patients received, n i.e. the ERAS group (n n=64) and the conventional group (n n=104), including 164 males and 4 females, whose ages ranged from 42 to 84 years old. The difference between two groups in the operative time, postoperative nutritional status, incidences of postoperative complications and postoperative hospitalization time were compared using the student′s n t test, Chi-squared test or Fisher′s exact test.n Results:Compared with the conventional group, patients in the ERAS group had significantly shorter operative time [(166.8±58.2) min n vs. (183.3±39.9) min,n t=-2.72, n P=0.031], higher levels of postoperative serum albumin [(38.3±4.2) μmol/Ln vs. (36.6±3.3) μmol/L, n t=2.73, n P=0.007] and more body weight [(65.4±9.4) kg n vs. (62.1±9.4) kg, n t=2.22, n P=0.028], lower incidences of postoperative subcutaneous infection [7.8% (5/64) n vs. 20.2% (21/104), n χ2=4.64, n P=0.03] and severe pneumonia [4.7% (3/64) n vs. 15.4% (16/104), n χ2=4.52, n P=0.03], and shorter postoperative hospitalization time [(16.5±3.9) d n vs. (18.2±4.3) d, n t=-2.65, n P<0.05].n Conclusion:ERAS is effective and safe in the surgical management of HSCC, with benefits in reducing the operative stress via saving operation time, shortening the hospitalization time, ameliorating nutritional status and decreasing the incidences of complications.
其他文献
融资租赁是五十年代初首先在美国企业界出现的一种融资技术,又称为金融租赁。它是由出租人购买承租人选定的机器设备,并按照协定将设备出租给承租人使用的一种融资技术。融
会议
从1981年美国的泰伦斯·狄尔和爱伦·肯尼迪提出企业文化至今,随着研究的不断深入,企业文化内涵不断丰富,为现代企业管理带来了全新领域。随着市场竞争以及WTO的加入,对国内商业
我国历史上的公家收藏和民间收藏,都是对祖国文明载体的积累和保护,并进行科学研究,总结发展的历史轨迹,以推动人类文明的进步。至于藏品的出版和展览,则是普及文化知识、精
会议
  LiFePO4 has emerged as one of the most promising cathode materials for large-size lithium-ion batteries in applications related to power tools,electric vehi
会议
会议
秋季栽培的西红柿、黄瓜、番瓜,其育苗期往往赶在高温多雨的夏季,苗期病害发生较重,因此床土应进行药物消毒处理。 1、播种前2~3星期将床土耙松,每平方米床土用福尔马林0.25
会议
会议