基于快速康复外科理论的多模式镇痛在腹腔镜结直肠癌根治术中的应用
徐珂嘉;苏喆;钱刚;陶伟民;张光明;
摘要(Abstract):
目的探讨基于快速康复外科(FTS)理论的多模式镇痛在腹腔镜结直肠癌根治术中的应用价值。方法将58例行腹腔镜结直肠癌根治术患者随机分为两组各29例,观察组在FTS理论指导下行多模式镇痛,对照组应用传统围手术期疼痛管理模式,比较两组术后视觉模拟评分(VAS)、恢复情况及并发症。结果与对照组比较,观察组术后6、12、24 h的VAS均降低,术后首次排便时间、排气时间、下床活动时间及住院时间均缩短,并发症总发生率降低,P均<0.05。结论 FTS理论下多模式镇痛可减少手术创伤与应激反应,提高腹腔镜结直肠癌根治术后疼痛控制质量,加快术后的康复进程。
关键词(KeyWords): 结直肠癌;腹腔镜;快速康复外科;多模式镇痛
基金项目(Foundation):
作者(Author): 徐珂嘉;苏喆;钱刚;陶伟民;张光明;
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参考文献(References):
- [1]Lezoche G,Baldarelli M,Campagnacci R,et al.Laparoscopic surgery of rectal cancer:state of art and long-term results[J].Ann Ital Chir,2010,81(4):265-268.
- [2]Krane MK,Fichera A.Laparoscopic rectal cancer surgery:where do we stand[J].World J Gastroenterol,2012,18(46):6747-6755.
- [3]Tsikitis VL,Holubar SD,Dozois EJ,et al.Advantages of fasttrack recovery after laparoscopic right hemicolectomy for colon cancer[J].Surg Endosc,2010,24(8):1911-1916.
- [4]Kehlet H.Fast-track surgery-an update on physiological care principles to enhance recovery[J].Langenbecks Arch Surg,2011,396(5):585-590.
- [5]高婧,朱桂玲.腹腔镜与快速康复外科结合在结、直肠癌根治术围手术期的应用[J].中国伤残医学,2011,19(2):1-3.
- [6]Liu S,Zhou Y.Perioperative standardized management under the guidance of fast track surgery in gastric cancer patients[J].Pancreatology,2015,15(7):185-190.
- [7]Chen WK,Ren L,Wei Y,et al.General anesthesia combined with epidural anesthesia ameliorates the effect of fast-track surgery by mitigating immunosuppression and facilitating intestinal functional recovery in colon cancer patients[J].Int J Colorectal Dis,2015,30(4):475-481.
- [8]薛官国.基于快速康复理念下腹腔镜胆囊切除手术患者的麻醉管理[J].北京医学,2015,53(10):117-119.
- [9]Baird G,Maxson P,Wrobleski D,et al.Fast-track colorectal surgery program reduces hospital length of stay[J].Clin Nurse Spec,2010,24(4):202-208.
- [10]王立婷,吴安石.术后镇痛与快速康复外科[J].北京医学,2015,37(8):774-776.
- [11]朱丽,赵梅珍.快速康复外科多模式镇痛在肠道手术病人中的应用[J].全科护理,2015,13(6):481-483.
- [12]李显蓉,盛云建,杨庆强.快速康复外科在腹腔镜结直肠癌根治术围手术期应用疗效的荟萃分析[J].实用医学杂志,2012,28(8):1265-1268.
- [13]李志超,王煜,王小成,等.基于快速康复外科理念的疼痛管理模式在日间腹腔镜胆囊切除术的应用[J].华西医学,2015,30(5):804-806.
- [14]Feroci F,Lenzi E,Baraghini M,et al.Fast-track colorectal surgery:protocol adherence influences postoperative outcomes[J].Int J Colorectal Dis,2013,28(1):103-109.
- [15]American Society of Anesthesiologists Committee.Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration:application to healthy patients undergoing elective procedures:an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters[J].Anesthesiology,2011,114(3):495.