快速康复方案在肛肠外科围手术期的临床研究

Clinical research of fast track program in anorectal surgery perioperative period

目的 研究快速康复方案在肛肠外科围手术期的安全性及有效性.方法 将169例结直肠、肛管恶性肿瘤围手术期患者按随机数字表法分为快速康复治疗方案组（观察组）86例与传统治疗方案组（对照组）83例,比较两组患者术后开始下床活动时间、首次肠道排气时间、停止静脉输液时间、住院时间、治疗费用及术后并发症的发生情况.结果 观察组术后首次肠道排气时间（33.6±12.9）h,停止静脉输液时间（4.5±1.3）d,住院时间（5.6±1.2）d,治疗费用（1.5±0.3）万元,对照组分别为（81.7±20.1）h、（7.4±1.6）d、（8.9±2.7）d、（1.6±0.4）万元,两组比较差异均有统计学意义（P＜0.01或＜0.05）;观察组术后并发症的发生率[5.8%（5/86）]明显低于对照组[16.9%（14/83）]（P＜0.05）.结论 快速康复方案在肛肠外科围手术期的应用安全、有效、有益.

Objective To study the safety and efficacy of fast track program in anorectal surgery perioperative period. Methods One hundred and sixty-nine cases of rectal cancer were divided into the study group of 86 patients with fast track program, and the control group of 83 patients with traditional programs by random digits table. Both groups were compared from the time out of bed, the first intestinal discharge time,intravenous fluids stopping time,length of hospital stay,total cost of treatment and the incidence of postoperative complications. Results The study group compared with the control group： the first intestinal discharge time [（33.6 ± 12.9） h vs. （81.7 ± 20.1） h], intravenous fluids stopping time [（4.5 ±1.3） d vs.（7.4 ± 1.6） d],and length of hospital stay [（5.6 ± 1.2） d vs.（8.9 ±2.7） d],the total cost of treatment [（15 000 ± 3000） yuan vs. （16 000 ± 4000） yuan], the differences were statistically significant （P 〈 0.01 or 〈 0.05）,and had less incidence of postoperative complications in study group than that in control group [5.8% （5/86） vs. 16.9% （14/83）], the difference was statistically significant （P 〈 0.05）.Conclusions Fast track program in anorectal surgery perioperative period is safe and effective, beneficial,conducive to rehabilitation of patients.