国际麻醉学与复苏杂志   2016, Issue (10): 8-8
    
快通道麻醉在结直肠肿瘤ERAS中的应用
刘鲜艳, 李胜1()
1.湖南省邵阳市中心医院
Fast-Track Anesthesia in Enhanced Recovery After Surgery of Colorectal carcinoma
 全文:
摘要:

摘要 目的: 探讨快通道麻醉应用于结直肠道肿瘤患者术后快速康复中的可行性。方法: 将需手术治疗的104例择期结直肠肿瘤患者分为传统对照组(52例)和快康观察组(52例), 其中快康观察组按快通道麻醉方法进行麻醉,传统对照组按传统麻醉方法进行麻醉,观察并比较两组麻醉前(T0)、气管插管后5min(T1)、切皮时(T2)、 探查时(T3)、拔气管插管后5min(T4)的心率(HR)及平均动脉压(MABP)的变化,观察患者全身麻醉药异丙酚及肌肉松弛药维库溴铵的用量、术毕至气管导管拔除所需时间、肛门排气时间、术后住院时间,统计术后并发症肺部感染和吻合口漏的发生率。结果:快康观察组手术过程中心率、血压波动较传统对照组平稳。快康观察组术中麻醉药物的用量明显比传统对照组要少(异丙酚286.5±26.4mg VS 286.5±26.4mg; 维库溴铵13.6±2.5mg VS 15.8±2.3mg),快康组患者术后苏醒时间(13.5±3.5min VS 26.4±12.8min)、肛门恢复排气时间(26.4±12.8h VS 53.6±18.5h)、术后住院时间(5.6±1.3d VS 8±2.6d )及肺部感染发生率(3.85% VS 9.62%)均小于传统对照组,差异有统计学意义(P<0.05),两组吻合口漏发生率差异无统计学意义(P>0.05)。结论:快通道麻醉贯穿整个围手术期,对促进患者术后快速康复起着重要作用。

关键词: 快通道麻醉;快速康复;结直肠手术
Abstract:

【Abstract】 Objective To explore the feasibility of the Fast-Track Anesthesia in the Enhanced Recovery After Surgery of Colorectal carcinoma. Methods 104 colorectal carcinoma patients which were randomly divided into the conventional control group (52 cases) and the enhanced recovery group(52 cases) were analyzed in the study . Results The heart rate and the fluctuation of blood pressure in the enhanced recovery group were more stable than those of the conventional control group. Besides, the general anesthetics in the enhanced recovery group was significantly less than that in the conventional control group (Propofolum 286.5±26.4mg VS 286.5±26.4mg; Vecuronium 13.6±2.5mg VS 15.8±2.3mg), and the recovery time(13.5±3.5min VS 26.4±12.8min), the time of anus exhaust(26.4±12.8h VS 53.6±18.5h), the length of hospital stay(5.6±1.3d VS 8±2.6d ) and the incidence of pulmonary infection(3.85% VS 9.62%) in the patients were less than those in the control group(P<0.05). Conclusion The Fast-Track Anesthesia was performed through the entire perioperative period, and played an important role in the Enhanced Recovery After Surgery of Colorectal carcinoma.

Key words: Fast-Track Anesthesia; Enhanced Recovery After Surgery; Colorectal carcinoma.