Clinical Application of the Fast Track Surgery Model Based on Preoperative Nutritional Risk Screening in Patients with Esophageal Cancer

基于营养风险筛查的快速康复外科在食管癌围手术期中的应用

Jin-Yi Wang ； Xuan Hong ； Guo-Han Chen ； Qin-Chuan Li ； Zhong-Min Liu

《Asia Pacific Journal of Clinical Nutrition》 24卷2期 (2015/06) Pp. 206-211

https://doi.org/10.6133/apjcn.2015.24.2.18

摘要

目的：探讨基于营养风险筛查（nutritional risk screening, NRS）的快速康复外科（fast track surgery, FTS）模式在食管癌患者围手术期治疗中的临床应用。方法：选取2008年01月至2014年04月同期住院食管鳞癌适宜手术治疗的患者180例随机分为两组（n=90）：研究组术前采用营养风险筛查2002（NRS2002）方法进行评估并予以干预性治疗；对照组按传统围手术期方法（conventional perioperative management）治疗。观察两组病例术后首次排气、排便时间、拔除胸腔引流管时间、术后住院时间以及手术并发症等情况。结果：两组手术时间差异无统计学意义（p＞0.05）。与对照组比较，研究组术后首次排气时间[88.4±2.76hvs57.8±2.68h]、首次排便时间[4.68±1.71dvs3.28±1.34d]、拔除胸腔引流管时间[4.30±0.25dvs2.70±0.33d]、术后住院时间[11.7±1.39dvs9.00±0.78d]以及总并发症发生率[18.9%（17/90）vs6.67%（6/90）]等均显著减少，其差异具有统计学意义（p＜0.05）。结论：应用基于营养风险筛查的FTS模式，可有效促进食管癌患者术后的康复，减少术后并发症的发生率，缩短住院时间，从而改善患者的临床疗效。

關鍵字

食管肿瘤 ； 围手术期 ； 营养风险筛查 ； 快速康复外科 ； 术后指标

並列摘要

Objectives: To investigate the clinical application of the fast track surgery (FTS) model based on preoperative nutritional risk screening (NRS) in patients with esophageal cancer. Methods: 180 patients with esophageal cancer who underwent surgery between January 2008 and April 2014 were randomly divided into study and control groups based on matched-pairs. The study group underwent assessment using the NRS 2002 and received treatment before surgery and the control group was treated by the conventional method. Postoperative indicators including time to first exsufflation, time to defecation, time to chest tube removal, hospitalization duration, and postoperative complications were examined after surgery. Results: Compared with the control group, the postoperative indicators including time to first exsufflation (88.4±2.76 vs 57.83±2.68 hours), time to first defecation (4.68±1.71 vs 3.28±1.34 days), time to chest tube removal (4.30±0.25 vs 2.70±0.33 days), postoperative hospitalization durations (11.71±1.39 vs 9.00±0.78 days), and total complication rate (18.9% [17/90] vs 6.67% [6/90]) were all significantly reduced in the study group (p＜0.05). Conclusions: The FTS model based on NRS can effectively promote postoperative rehabilitation of patients, reduce the incidence of postoperative complications, and shorten hospital stay.

並列關鍵字

esophageal cancer ； perioperation ； nutrition risk screening ； fast track surgery ； postoperative indicator