加速康复外科策略对腹腔镜结直肠癌手术患者术后早期认知功能的影响

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1、授予单位代码10089学号或申请号16107中国图书分类号R614HebeiMedicalUniversity硕士学位论文学术学位加速康复外科策略对腹腔镜结直肠癌手术患者术后早期认知功能的影响研究生：靳红绪导师：黄立宁副教授专业：麻醉学二级学院：第二医院2018年3月目录中文摘要·······································································································1英文摘要················

2、·······················································································4英文缩写·······································································································7研究论文加速康复外科策略对腹腔镜结直肠癌手术患者术后早期认知功能的影响前言·······························

3、········································································8材料与方法·······························································································9结果························································································

4、···············14附表·······································································································15讨论·······································································································19结论·······························

5、········································································25参考文献····························································································25综述加速康复外科在围术期麻醉中的应用进展·································29致谢···································

6、····································································39个人简历·······································································································40加速康复外科策略对腹腔镜结直肠癌手术患者术后早期认知功能的影响摘要目的：通过按照加速康复外科（ERAS）策略对腹腔镜结直肠癌手术患者围术期进行一系列优化处理，探讨其对结直

7、肠癌手术患者术后早期认知功能的影响，为此类患者的围术期处理方法的选择提供参考。方法：选择2017年1月至2017年10月衡水市哈励逊国际和平医院择期拟行腹腔镜结直肠癌根治术患者60例，采用计算机随机分组法将其随机分为ERAS方案组（E组，n=30）和常规围术期处理组（C组，n=30）。E组进行医护一体围术期管理，术前加强ERAS知识宣教，戒烟和呼吸功能锻炼，给予营养支持并让患者在麻醉前12h进食富含碳水化合物的清液800ml，麻醉前2～3h进食清液400ml。麻醉方式采用全麻复合连续胸段硬膜外麻醉，术中采取保温措施，限制性

8、补液方案，术中完善镇痛、术后多模式镇痛，鼓励术后早期进食进水和下床活动等一系列快速康复外科策略进行围术期管理。C组采用传统常规围术期处理和监测手段，以常规方法补液。患者入室后未做保温处理，所输液体及腹腔冲洗液亦未做加温处理；未进行硬膜外阻滞，术后镇痛采用静脉自控镇痛（PCIA）。比较两组患者的性别比、年