加速康复外科在腹腔镜肾癌根治术中应用的安全性及有效性研究

Efficacy and safety of fast track surgery strategy for patients undergoing laparoscopic radical nephrectomy

目的:探讨加速康复外科(fast track surgery,FTS)对腹腔镜肾癌根治术的影响。方法:将同期入院的60例腹腔镜肾癌根治术患者随机分为两组,分别采用加速康复(FTS组)及常规围手术期处理(对照组)方案,对比分析两组患者术后通气时间、开始进食时间、导尿管与引流管留置时间、术后住院时间、住院费用、并发症发生率、疼痛评分等,患者均在满足出院标准的情况下安排出院。结果:FTS组通气时间、首次下床活动时间、开始进食时间明显提前,导尿管与引流管留置时间、术后住院时间、住院费用明显减少,术中、术后并发症两组差异无统计学意义,术后24 h、48 h咳嗽状态评分两组相比差异有统计学意义。结论:加速康复外科应用于腹腔镜肾癌根治术是安全、有效的,可加速患者的康复。

Objective ：To evaluate the impact of fast track （FTS） surgery on recovery after laparoscopic radical nephrectomy. Methods：Sixty patients were randomly assigned to fast tract groups and conventional groups （n = 30 in each group）. These patients undergoing laparoscopic nephrectomy received either conventional care or an FTS recovery program. The first time of flatus, time of oral nutrition, time of drain and transurethral catheterization usage, time of mobilization, hospital discharge times after surgery, hospitalization expenses , incidence of intraoperative and postoperative complications, and visual analogue scale （VAS） pain scores were compared between the two groups. Results： As compared with the control group,the first time of flatus ,time of oral nutrition were markedly shortened in the study group （ P 〈 0. 01 ）, so were time of drainage and transurethral catheterization usage, length of hospital stay and the hospitalization expenses （P 〈 0.01 ）, whereas the incidence of intraoperative and postoperative complications did not differ significantly （P 〉 0.05）. Pain scores were consistently lower in the VFS group during the 24 h and 48 h after surgery when they cough. Conclusions： FAS within laparoscopic radical nephrectomy is safe and feasible ,which could led to accelerate rehabihtation.