加速康复措施对肝硬化门静脉高压患者外科治疗预后影响的研究

Effect of fast-track rehabilitation on liver cirrhosis patients with portal hypertension after surgical therapy

目的:探讨肝硬化门静脉高压手术治疗安全性及减少术后并发症、加快康复的有效方法。方法:根据前瞻性和随机性原则,将肝硬化门静脉高压患者46例分为加速康复组(26例)与传统治疗组(20例)。加速康复组运用加速康复外科理念,观察2组患者术后并发症发生率、重要脏器功能恢复及术后康复时间。结果:加速康复组与传统治疗组比较,胃肠功能恢复较快(P<0.01),血浆用量和平均营养费用较少(P<0.01),住院时间缩短(P=0.039),总并发症减少(P=0.001);术后8 d血清前白蛋白和转铁蛋白已恢复到术前水平,与对照组比较差异有统计学意义(P<0.05)。结论:充分掌握肝硬化门静脉高压病理生理特点,运用加速康复措施,可有效减少手术并发症的发生,加速术后康复。加速康复措施对肝硬化门静脉高压术后患者是一种安全、有效、合理的治疗措施。

Objective：To evaluate the prognosis impact of fast-track rehabilitation on liver cirrhosis patients with portal hypertension after surgical therapy.Methods： Forty six liver cirrhosis patients with portal hypertension were selected and divided into FTS group and traditional therapy group according to prospective and random principles.The fast-track surgery measure was applied on FTS patients,and the post-operative complications,functional recovery of important organs and post-operative rehabilitation time were investigated.Results： Compared with control group,the FTS group had shorter time of gut function,less blood plasma usage,less nutritional drugs costs（P〈0.01）,shorter hospital stay time（P=0.039） and fewer total complications（P=0.001）.In FTS group,the serum prealbumin and transferrin level neared the preoperative level on post-operative eighth daywith significant difference（P〈0.05） compared with control group.Conclusion： The application of TFTS measure after mastering physiopathologic characteristics could effectively decrease post-operative complications and promote post-operative rehabilitation.The FTS measure is safe,rational and effective on liver cirrhosis patients with portal hypertension.