快速康复理念在肝癌肝切除术围手术期处理中的应用

Application of fast track surgery in perioperative management of patients with hepatic cancer

目的:评估快速康复外科(FTS)理念应用于肝癌切除术患者围手术期的优越性。方法:297例肝细胞性肝癌患者被随机分为FTS组(135例)和对照组(162例),FTS组采用FTS理念指导下的围手术期处理措施,对照组采用传统围手术期处理措施,比较分析两组患者术中情况,术后肠道功能恢复时间、术后住院天数、住院费用、术后不良反应及并发症情况。结果:与对照组比较,FTS组手术时间明显缩短,术后肠道功能恢复时间明显提前,术后住院天数缩短,住院费用降低;差异均有统计学意义(均P<0.05)。并发症情况两组无统计学意义(均P>0.05)。结论:FTS理念应用于肝癌切除术患者围手术期的处理安全有效的,可加速患者的康复进程。

Objective： To assess the advantages of using fast track surgery （FTS） during perioperative period in patients undergoing hepatectomy for liver cancer. Methods： Two hundred and ninety-seven patients with hepatocellular carcinoma were randomly designated to either FTS group （135 cases） or control group （162 cases） adopting the traditional perioperative treatment measures. The patients in FTS group received the perioperative management pathway guided by the FTS concept, while those in control group underwent conventional perioperative treatment. Comparisons were made between the two groups with respect to the intraoperative conditions, time to postoperative recovery, length of hospital staff cost of hospital admission, and postoperative adverse events and complications. Results： In FTS group, the operative time was shorter, intestinal function recovery was earlier, and both hospital stay and cost were reduced compared with control group, and all the differences reached statistical significance （all P〈0.05）. However, no difference was noted in the postoperative adverse events andcomplications between the two groups （all P〉0.05）. Conclusion： Using FTS concept in the perioperative management of patients undergoing hepatectomy for liver cancer is safe and effective, and it can accelerate the postoperative recovery of these patients.