摘要
目的研究加速康复外科(ERAS)模式对腹腔镜下胰十二指肠切除术(LPD)术后患者的肠黏膜屏障功能的影响。方法回顾性分析2015年1月至2018年12月接受LPD术的患者145例,根据干预方案不同分为ERAS组78例及传统组67例。数据采用SPSS 24.0进行统计学分析,术后并发症发生率等计数资料采用χ^2检验;围术期各项指标、肠黏膜屏障功能指标以(±s)表示,独立t检验;P<0.05为差异有统计学意义。结果ERAS组术后恢复情况均优于传统组,其中首次排气时间、首次进食时间、引流管拔管时间及术后住院时间差异均有统计学意义(P<0.05);两组术后死亡率差异无统计学意义(P>0.05);ERAS组患者胃排空延迟的发生例数(3例,3.8%)明显少于传统组(5例,7.5%)(P<0.05),其余并发症比较差异无统计学意义(P>0.05);两组患者术后肠黏膜屏障功能指标ERAS组患者优于传统组,但差异无统计学意义(P>0.05)。结论加速康复外科能使LPD术获得更好的临床效果,并可促进LPD患者术后肠黏膜屏障功能的恢复。
Objective To investigate the intestinal mucosal barrier function of patients after LPD based on ERAS principles.Method A retrospective analysis was performed in 145 patients with LPD from January 2015 to December 2018,who were divided into ERAS group(78 cases)and traditional group(67 cases)according to perioperative treatment protocols.Statistical analysis were performed by using SPSS24.0 software.Measurement data such as perioperative indicators and intestinal mucosal barrier function were represented as and were examined by using independent t test.Postoperative complications were expressed as n(%)and were analyzed by usingχ^2 test.Kaplan-meier method was used for survival analysis.A P value of<0.05 was considered as statistical significant difference.Results The postoperative recovery in the ERAS group were significantly better than those in the traditional group,in terms of first exhaust time,first oral-feeding time,drainage tube extubation time and postoperative hospitalization time(P<0.05).However,there was no significant difference between two groups of mortality rate(P>0.05).The incidence of 3.8%gastric emptying delay in ERAS group(3 cases)was significantly less than 7.5%in traditional group(5 cases),with significant difference(P<0.05).There was no significant difference between two groups of other complications rate(P>0.05).There was no significant difference between two groups of intestinal mucosal barrier function after LPD(P>0.05).Conclusion Based on ERAS principles,better clinical effect could be achieved after LPD with improved intestinal mucosal barrier function.
作者
耿炜
彭金茹
赵雪琪
曹晓雯
崔利红
Geng Wei;Peng Jinru;Zhao Xueqi;Cao Xiaowen(Xi’an International Medical Center Hospital,Shaanxi 710100,China;Tangdu Hospital The Fourth Military Medical University)
出处
《中华普外科手术学杂志（电子版）》
2020年第3期260-263,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
陕西省自然科学基金资助项目(2017068625)。
关键词
胰十二指肠切除术
加速康复外科
康复
肠黏膜
Pancreaticoduodenectomy
Enhanced recovery after surgery
Rehabilitation
Intestinal mucosa
