快速康复外科应用于胃肠手术的安全性评估及个体化原则

The safety and individuation principle of fast-track surgery applied in gastrointestinal surgery

目的:探讨快速康复外科(FTS)应用于胃肠手术的安全性及个体化原则。方法:将采用FTS方法进行围手术期处置的180例择期胃肠手术患者(FTS组)与采用标准方法处理的110例患者(传统组)进行非随机对照研究,比较其一般并发症、严重并发症、消化道瘘和总体并发症发生率的差异。结果:FTS组的总体并发症及一般并发症发生率均显著低于传统组(P<0.05);两组的严重并发症发生率虽差异无显著性(P>0.05),但FTS组的消化道瘘发生率较传统组有增高趋势(2.2%vs0.9%,P>0.05)。结论:FTS可显著降低胃肠手术后的并发症发生率,但如应用不当可能增加消化道瘘的发生率,因此,FTS的临床应用应遵循个体化原则。

Objective To evaluate the safety and individuation principal of fast-track surgery applied in gastrointestinal surgery. Methods Complications after elective gastrointestinal surgery in patients with either a fasttrack program （FTS group, n=lSO） or standard care （conventional grnup,n=110） were analyzed. Results As compared with those in conventional group, the general and common complications in FTS group were significantly reduced （P 〈 0.05）, the serious complication was not significantly different （P 〉 0.05）, but the rate of digestive fistula was higher （2.2% vs 0.9%,P 〉 0.05）. Conclusions The fast-track surgery can significantly reduce the complications after gastrointestinal surgery, but may increase digestive fistula when implemented erroneously. Therefore, implementation of fast-track surgery should follow the principle of individuation.