| Objective To investigate the clinical value of Enhanced Recovery after Surgery(ERAS)in radical resection of Primary Liver Cancer.Methods The Clinicopathological data of 68 patients with Primary Liver Cancer who were admitted to the Northern Jiangsu People's Hospital from June 2016 to November 2017 were admitted in this prospective study.According to the random number table,all the patients were randomly assigned into the observation group and control group.Then,the observation group adopted the perioperative management strategy which was conducted by the process of ERAS,compared with control group adopting the traditional strategy.Observation index:(1)Intraoperative situation: volume of intraoperative intravenous fluid,intraoperative blood glucose,first hilar block time,volume of Intraoperative blood loss,the size and position of liver tumor,operation time;(2)Postoperative efficacy: extent of postoperative blood glucose,levels of alanine transaminase(ALT),aspartate aminotransferase(AST),direct bilirubin(DBil),total bilirubin(TBil),white blood cell(WBC),Hemoglobin(HGB),the time to flatus,the time to urinary catheter removal,postoperative hospital days,satisfaction degree of Patients(0—10);(3)Visual analogue scale(VSA)scores on postoperative 24h;(4)Nutritional status: levels of serum total protein(TP),albumin(ALB);(5)Incidence of postoperative complications;(6)Follow-up situation: follow-up was performed to detect the survival of patients and unscheduled readmission up to January 2018.Results:All patients were treated successfully and discharge uneventfully,and no patient died perioperatively in the both of groups.volume of intraoperative intravenous fluid was(1995±584)ml and(2393±583)ml in the ERAS group and control group respectively,there were significant differences between the two groups(t=2.812,P<0.05),intraoperative blood glucose,first hilar block time,volume of Intraoperative blood loss,the size and position(<3 segment,?3 segment)of liver tumor,operation time were(8.3±2.6)mmol/L,(12±17)min,(267±213)ml,(5.7±2.6)cm,(180±54)min,(30,5case)in the ERAS group,and(8.9±1.9)mmol/L,(13±12)min,(271±219)ml,(5.2±3.1)cm,(158±52)min,(25,8)in the control group respectively,with no significant differences in both of these groups(t=1.132,0.069,0.067,0.698,1.753,X2=1.089,P>0.05);(2)postoperative efficacy: Residence time in the Postanesthesia care unit,extent of postoperative blood glucose during 3 days after surgery,WBC at the 5 day postoperatively,the time to flatus,postoperative hospital days,satisfaction degree of patients were(56.5±10.2)min,(9.1±2.6)mmol/L,(7.9±1.9)mmol/L,(8.3±2.3)mmol/L,(12.1±4.1)×109/L,(39.1±15.4)hours,(8.1±2.0)days,(8.60±0.91)in the ERAS group,and(62.2±9.1)min,(11.0±3.1)mmol/L,(11.3±2.6)mmol/L,(10.4±2.3)mmol/L,(14.3±4.2)×109/L,(46.5±9.8)hours,(10.4±6.2)days,(8.03±1.18)in the control group respectively,with significant differences in both of these groups(t=2.407,2.830,6.158,3.812,2.150,2.354,2.056,2.227,P<0.05);(3)Visual Analogue Scale(VAS)scores on postoperative 24 h was(2.3±1.9),(3.4±2.1)in the ERAS group and control group respectively,with significant differences between the two groups(t=2.023,P<0.05);(4)Nutritional status: levels of TP and ALB at the 5 day postoperatively were(63.4±7.3)g/L,(38.0±3.6)g/L in the ERAS group,and(59.1±6.0)g/L,(34.6±3.2)g/L in the control group respectively,with significant differences between the two groups(t=2.875,4.108,P<0.05);(5)Incidence of postoperative complications: the postoperative complications of the two groups were no significant differences(X2=0.032,P>0.05);Conclusion The application of ERAS programs is safe and effective for patients after radical resection of Primary Liver Cancer,and it can reduce adequately extent of postoperative blood glucose and the inflammatory reaction,accelerate the recovery of liver function and nutrition level,shorten the postoperative days,improve patients' satisfaction,which contributes to postoperative recovery of patients sufficiently. |
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