快速康复外科理念在胆道外科围术期中的应用

Application of Fast Track Surgery Management in Perioperative Period of Biliary Surgery

目的探讨快速康复外科(fast track surgery,FTS)理念在胆道外科围术期中应用的安全性和有效性。方法将600例择期行胆道手术患者,随机分为FTS组309例和对照组291例,FTS组采用FTS理念指导下的优化围术期处理方法,主要包括缩短患者术前的禁食时间,术前口服含碳水化合物的液体,不留置胃管、尿管,尽量不放置腹腔引流管,术后早期进食,尽早下床活动等;对照组采用传统的围术期处理方法。观察两组术后排气排便时间、住院天数、住院费用、术后并发症情况。结果 FTS组不同术式术后排气排便时间和住院时间均较对照组缩短、住院费用均低于对照组(P<0.05,P<0.01),两组并发症发生率比较差异无统计学意义(P>0.05)。结论 FTS理念在胆道外科围术期处理中的应用安全、有效,可加速患者的康复进程。

Objective To investigate the safety and effectiveness of fast track surgery （FTS） management in perioperative period of biliary surgery. Methods 600 patients undergoing elective biliary surgery were randomly divided into FTS group （n = 309） and control group （n = 291 ）. FTS group received FTS care in the perioperative period, which included shortened preoperative fasting time, no nasogastric decompressing tubes, no foley catheter and abdominal drainage placed, early postoperative oral feeding and mobilization, whereas the control group was treated with traditional protocol. The effects of postoperative bowelventing, hospital stay time, medical treatment cost, complications incidence were compared between these two groups. Results The FTS group had accelerated recovery of bowel function, decreased hospital stay time, and reduced medical treatment cost, compared to the control group （ P 〈 0.05, P 〈 0. 01 ）. There was no significant difference in the postoperative complications or side effects between these two groups （ P 〉 0.05 ）. Conclusion FTS management in biliary surgery patients is safe and efficient, which could accelerate the recovery after surgery.