| Objective: In this study,by comparing and analyzing the patients with gastric cancer undergoing Enhanced recovery after surgery(ERAS)and traditional perioperative treatment in our hospital,the clinical effect of ERAS in laparoscopic radical gastrectomy was discussed,so as to provide reference for promoting the clinical application of ERAS,provide evidence for rational formulation and revision of ERAS scheme,and provide suggestions for further exploring the core elements of ERAS scheme.Methods: The clinical data of 196 patients who met the standard of limited laparoscopic radical gastrectomy from January 2019 to December 2019 were analyzed retrospectively.These patients are all from the gastrointestinal surgery department of Yijishan Hospital of Wannan Medical College.Among them,120 patients received perioperative treatment of accelerated rehabilitation surgery for laparoscopic radical gastrectomy(hereinafter referred to as ERAS group),and 95 patients received traditional perioperative treatment for laparoscopic radical gastrectomy(hereinafter referred to as traditional group).Record the clinical indicators of the two groups of patients needed for this study,including: 1.General information: age,sex,tumor stage(TNM stage),operation mode;2.Clinical related indicators: operation time,intraoperative blood loss,indwelling time of urinary catheter,indwelling time of nasogastric tube,indwelling time of abdominal drainage tube,first postoperative anal exhaust time,postoperative drinking and eating time,postoperative hospitalization time and hospitalization expenses;3.Nutritional indicators: detect and record the results of pre-protein and albumin(ALB)on the first and fifth days after operation;Total amount of albumin used after operation;4.Inflammation index: the time of antibiotic use,the body temperature on the first,second and third days after operation,the number of white blood cells and the percentage of neutrophils on the first and fifth days after operation were detected and recorded;5.Pain index: Record the pain score(NRS)on the 1st,2nd and 3rd day after operation;6,complications,and statistical processing and evaluation analysis.Results: 1.There was no significant difference in age,sex,tumor stage(TNM stage)and operation mode between the two groups(P>0.05).2.There was no significant difference in operation time between the two groups [(214.1363.08)min vs.(225.72 61.25)h,t =-1.352,p = 0.177].Compared with the traditional group,the bleeding volume in ERAS group was less [(56.17 29.28)ml vs.(78.32 56.51)ml,t =-3.712,P < 0.001],and the intestinal function recovered quickly [(63.47 10.15)h vs.] P< 0.001],shorter postoperative hospital stay [(11.6 3.82)d vs.(13.44 6.69)d,t =-2.54,p =0.012],lower hospital cost [(50593.81 12469.81)yuan vs.3.Compared with the traditional group,the albumin level in ERAS group on the first day and the fifth day after operation was not significantly higher than that in the traditional group [(30.95 3.96)g/L vs.(31.74 3.89)g/L,t =-0.997 p = 0.32],[(31.34 4 4.10] T=0.150P=0.881],but the average use of albumin in ERAS group was less than that in traditional group [(36.50 51.46)g vs.(48.74 63.79)g,t =-1.557 p = 0.121].There was no significant difference between the two groups on the first day and the fifth day after operation.Compared with traditional group,the protein level in ERAS group was lower than that in traditional group [(16.60 5.55)g/L vs.(18.53 5.54)g/L,t =-2.167 p = 0.032] before the first day after operation,but higher than that in traditional group [(14.76 5.21)before the fifth day after operation.4.Compared with the traditional group,the number of white blood cells in ERAS group on the first day and the fifth day after operation was not significantly lower than that in traditional group [(87.86 5.46)% vs.(89.62 4.30)%,t =-2.351 p = 0.02],[(77.51 6.95)* 10]On the first day and the fifth day after operation,the percentage of neutrophils was better than that of the traditional group [(12.58 3.36)* 10 9 vs.(13.86 9.55)* 10 9,t =-1.178 p =0.24],[(8.51 2.81)% vs.Compared with the traditional group,the body temperature of ERAS group on the first and second day after operation was higher [(37.25 0.66)? vs.(36.94 0.55)?,t = 3.676 p < 0.01],[(37.09 0.53)? vs.(36.93)5.Compared with the traditional group,the pain scores of ERAS group on the first day,the second day and the third day after operation were significantly lower than those of the traditional group [(5.49 0.70)vs.(6.34 0.81),t =-7.106 p < 0.001],[(3.64 0.07)vs.6.Compared with the traditional group,the time of extubation in ERAS group was earlier than that in traditional group(P < 0.001),but there was no significant difference in complication rate between the two groups(P = 0.50).In addition,the pain scores in ERASgroup on the 1st,2nd and 3rd day after operation were significantly lower than those in traditional group [(5.49 0.70)vs.(6.34 0.81),t =-7.106 P < 0.001],[(3.64 0.07)vs.(5.21 11.0)(11.11%vs.7.95%,x2=0.456,P=0.50)?conclusion: Compared with the traditional perioperative plan of laparoscopic radical gastrectomy for gastric cancer,it has obvious advantages,such as less bleeding during operation,quick recovery of intestinal function after operation,better nutrition improvement,less inflammation and stress reaction,short hospitalization time,low hospitalization cost,and no increase of postoperative complications.It is safe,feasible and has good clinical effect for promoting postoperative recovery of patients. |
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