Fast-track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the effects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed. This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT group was better than the traditional group (p<0.05). Serum indicators for nutrition (HGB, ALB, A/G) and immune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the traditional group (p<0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation in the FT group was shorter when compared to the traditional group (p<0.05). The complication incidence was significantly lower in the FT group than in the traditional group (p<0.05). In particular, the occurrence rate of anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p<0.05). Taken together, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal surgical patients.
研究证明加速康复外科能够促进手术患者康复。本研究的目的是比较加速康复 外科流程与传统流程下的营养支持对患者术后康复的影响，同时探究加速康复 外科流程在结直肠手术患者营养支持方案中的临床适用性。本研究前瞻性地纳 入464 例结直肠癌手术患者，随机分为加速康复外科流程组(FT 组)和传统流程 组。终点指标为NRS2002，术后康复指标，术后并发症。FT 组NRS2002 评分 低于传统流程组(p<0.05)；FT 组血红蛋白，白蛋白，白球比及淋巴细胞比率、 IgA、CD4+等指标在术后第5 天均优于传统流程组(p<0.05)；FT 组首次排气、排 便、经口进食及下床活动时间短于传统流程组(p<0.05)；FT 组的并发症发生率低 于传统流程组(p<0.05)；传统流程组的吻合口瘘发生率高于FT 组(2.8%比上 0.5%，p<0.05) 。综上所述，本研究表明加速康复外科能够改善结直肠癌术后患 者的营养状态及临床效果。