基于加速康复外科的老年胃癌患者围手术期症状网络化精准方案应用效果研究 ^*

Application effects of a networked precision protocol based on enhanced recovery after surgery for perioperative symptoms in elderly gastric cancer patients

摘要

目的 探讨基于加速康复外科的围手术期症状网络化精准管理方案对老年胃癌患者症状负担、生活质量及术后康复的影响, 为优化老年胃癌患者围手术期管理提供循证依据。方法 选取2023年1月—2024年12月江苏省肿瘤医院普外科住院治疗的116例老年胃癌患者作为研究对象。按照随机数字表法将患者分为对照组和观察组, 各58例, 对照组实施常规围手术期干预, 观察组实施基于加速康复外科的症状网络化精准方案。采用MD安德森症状评估量表 (MDASI) 评估症状严重程度, 采用欧洲癌症研究与治疗组织生活质量核心问卷量表 (30条目版) (QLQ-C30) 评估患者的生活质量, 并比较术后康复指标及并发症发生情况。结果 观察组术后各时间点MDASI评分均低于对照组 (P<0.05)。术后第14天, 观察组整体健康状况和功能维度评分均高于对照组 (P<0.05), 症状维度评分低于对照组 (P<0.05)。观察组首次排气时间、首次进食时间、首次下床时间以及术后住院时间均短于对照组 (P<0.05)。观察组并发症总发生率低于对照组 (P<0.05)。结论 基于加速康复外科的症状网络化精准管理方案能有效降低老年胃癌患者围手术期症状严重程度, 为老年胃癌患者围手术期管理提供新路径。

Abstract

Objective To explore the effects of a networked precision management protocol based on enhanced recovery after surgery on symptom burden, quality of life, and postoperative recovery in elderly gastric cancer patients, and to provide evidence for optimizing perioperative management in this population. Methods A total of 116 elderly patients scheduled for radical gastrectomy admitted to the Department of General Surgery of Jiangsu Cancer Hospital from January 2023 to December 2024 were selected and randomly divided into a control group and an observation group, with 58 cases in each group. The control group received conventional perioperative care, while the observation group received the enhanced recovery after surgery based networked precision symptom management protocol. The MD Anderson symptom inventory (MDASI) was used to assess symptom severity, and the EORTC QLQ-C30 was used to evaluate the quality of life of patients, and postoperative rehabilitation indicators and incidence of complications were compared. Results The MDASI scores of the observation group were lower than those of the control group at all time points after surgery (P<0.05). On the 14th day after surgery, the overall health status and functional dimensions of the observation group were higher than those of the control group (P<0.05), and the symptom dimension score was lower than that of the control group (P<0.05). The observation group had shorter first exhaust time, first eating time, first getting out of bed time, and postoperative hospitalization time compared to the control group (P<0.05). The total incidence of complications in the observation group was lower than that in the control group (P<0.05). Conclusion The symptom networked precise management scheme based on enhanced recovery after surgery can effectively reduce the severity of perioperative symptoms in elderly gastric cancer patients, providing a new path for perioperative management of elderly gastric cancer.

关键词

加速康复外科 / 胃癌 / 手术 / 康复

Key words

Enhanced recovery after surgery / Gastric cancer / Surgery / Rehabilitation

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基金资助

^*国家自然科学基金委员会青年科学基金项目(82404002)