摘要
目的探讨3D腹腔镜辅助结肠癌根治术后患者早期经口进食的安全性及可行性。方法回顾性分析本中心2018年3月-2019年3月收治并行3D腹腔镜辅助结肠癌根治术的患者资料,共纳入114例患者,根据术后经口进食时间分为早期经口进食组(54例)及常规经口进食组(60例),比较两组患者进食耐受性、胃肠功能恢复时间、术后平均住院时间、住院费用、术后营养状况及并发症的发生率。结果两组患者基线资料无显著差异,与常规进食组相比,早期经口进食组术后首次排气时间[(2.4±1.2)d vs(3.5±1.4)d,P<0.001]和首次排便时间[(3.7±1.7)d vs(4.4±1.5)d,P=0.021]更早;术后平均住院时间更短[(5.3±2.1)d vs(6.7±2.6)d,P=0.002],住院费用更少[(1.3±0.4)万元vs(1.8±0.7)万元,P<0.001];术后第5天血清白蛋白[(37.7±4.3)g/L vs(35.4±4.6)g/L,P=0.007]及前白蛋白[(183.8.4±37.9)mg/L vs(171.0±29.5)mg/L,P=0.045]水平更高;两组患者进食耐受性及并发症发生率无统计学差异(P均>0.05)。结论3D腹腔镜辅助结肠癌根治术后患者早期经口进食是安全可行的,可加速患者胃肠功能恢复,改善术后营养状态,缩短住院时间并降低住院花费。
Objective To investigate the effect and safety of early oral feeding for patients with colon cancer after 3D laparoscopic radical colectomy.Methods Clinical data about 114 patients who received 3D laparoscopic radical colectomy in our center from March 2018 to March 2019 were retrospectively analyzed.According to the time of postoperative oral feeding,the patients were divided into early oral feeding group(54 cases)and routine oral feeding group(60 cases).The feeding tolerance,gastrointestinal function recovery time,average length of hospital stay and costs of hospitalization,nutritional status and postoperative complications were compared between the two groups.Results There was no significant difference in baseline data between the two groups.Compared with the routine oral feeding group,patients in the early oral feeding group had less time to first flatus([2.4±1.2]d vs[3.5±1.4]d,P<0.001)and less time to first stool([3.7±1.7]d vs[4.4±1.5]d,P=0.021),shorter average length of hospital stay([5.3±2.1]d vs[6.7±2.6]d,P=0.002)and less hospitalization cost([1.3±0.4]ten thousand yuan vs[1.8±0.7]ten thousand yuan,P<0.001).On the 5th day after surgery,patients in the early oral feeding group had higher serum albumin level([37.7±4.3]g/L vs[35.4±4.6]g/L,P=0.007)and prealbumin level([183.8.4±37.9]mg/L vs[171.0±29.5]mg/L,P=0.045).There was no significant difference in the feeding tolerance and complication rate between the two groups(P>0.05,respectively).Conclusion Early oral feeding in patients undergoing 3D laparoscopic radical colectomy is safe and feasible,which can accelerate the recovery of gastrointestinal function,improve the nutritional status,reduce the length of hospital stay and expenses without increasing the incidence of complications after operation.
作者
邱兆岩
鲁意迅
谢天宇
陈凛
QIU Zhaoyan;LU Yixun;XIE Tianyu;CHEN Lin(Department of General Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2020年第5期489-492,共4页
Academic Journal of Chinese PLA Medical School
