Clinical application of fast track surgery in perioperative management in elderly patients with hepatic cancer / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical effect and safety of fast track surgery in perioperative management in elderly patients with hepatic cancer.Methods 56 cases with hepatic cancer undergoing hepatic surgery were chosen,and randomly divided into observation group and control group (n=28 for each).Patients in observation group were treated with fast track surgery in perioperative management,and patients in control group were treated with conventional treatment.The C reactive protein level,liver function indexes,anal exhaust time,length of stay,adverse reactions and complications were compared between the two groups.Results The C reactive protein level had no difference between the observation group and control group 7 days after surgery [(8.6± 1.4) mg/L vs.(9.2± 2.1) mg/L,P＞0.05].There were significant differences in the levels of alanine aminotransferase,glutamic oxalacetic transaminase,total bilirubin and serum albumin between observation and control groups [(58.0±10.3)U/L vs.(100.3±25.7) U/L,(59.5±21.5) U/L vs.(99.1±29.7) U/L,(21.2±10.0) mmol/L vs.(35.9±8.6) mmol/L and (35.8±2.4) g/L vs.(32.1±2.1) g/L,all P＜0.001].The anal exhaust time and length of stay were less in observation group than in control group [(17.4±2.3) hours vs.(26.3±9.6) hours and (11.5±1.8) days vs.(14.8±3.4) days,both P＜0.001].There were 7 cases with nausea,4 cases with vomiting,8 cases with abdominal distention and 3 cases with abnormal liver function in observation group,and 9 cases with nausea,5 cases with vomiting,7 cases with abdominal distention and 4 cases with abnormal liver function in control group after surgery.There was no significant difference in the rate of adverse reactions between the two groups (P＞ 0.05).Conclusions Fast track surgery in perioperative management is safe for elderly patients with hepatic cancer,which can reduce the stress reaction,improve liver function,shorten anal exhaust time and length of stay,reduce complications and promote the rehabilitation,and it is worthy of clinical application.