胃肠手术快速康复外科治疗优化设计方案的临床研究

Clinical Research on the Optimized Design of Fast-Track Surgical Treatment in Gastrointestinal Surgery

目的讨论优化后的快速康复外科手术治疗方案并评价其效果。方法将我院收治的180例胃肠疾病患者分为快速康复组、优化组和传统手术组三个组别,分别采取快速康复外科治疗、优化后的快速康复外科治疗和传统的手术治疗,统计三组患者术中和术后有关指标以及并发症情况,评价三种方法的效果。结果优化组肛门恢复排气时间为(20±6.8)h,切口愈合时间为(7±1)d,术后住院时间为(7±1)d,咽喉疼痛、恶心呕吐、切口感染、肺部感染分别为1、2、0、0例,上述指标和并发症与康复组和传统组相比,有统计学差异,P<0.05。就治疗费用而言,优化组为(7891±671.4)元,明显高于康复组和传统组,P<0.05。在其他指标和并发症方面与康复组并没有统计学差异,P>0.05。结论优化后的快速康复外科治疗可以缩短患者住院时间、降低并发症情况,促进肛门恢复排气和切口愈合,但是治疗费用相对较高,对于经济因素影响不显著的患者较为适用。

Objective To discuss the scheme and evaluate the effect of optimized fast-track surgical treatment. Methods A total of 180 patients with gastrointestinal illness were divided into three groups： the fast-track group received fast-track surgical treatment, the optimized group received optimized fast-track surgical treatment, and the traditional surgery group received traditional surgical treatment. Intraoperative and postoperative indicators and incidence of complication of the three groups were compared to evaluate the effect of the three troatments Results In the optimized group, the anus exhaust time was （20±6.8） h, incision healing time was （7 ± 1） d, postoperative hospital stay was （7 ± 1） d, the cases of sore throat, nausea vomiting, incision infection and pulmonary infection were 1, 2, 0, 0 respectively. The above indicators were significantly different from those in the fast-track group and the traditional group （P 〈0.05）. The treatment cost was （7 891±671.4） Yuan in the optimized group, significantly higher than that in the fast-track group and the traditional group （P 〈0.05）. Other indicators and incidence of complication showed no significant difference among the three groups （P 〉0.05）. Conclusions The optimized fast-track surgical treatment has advantages in shortening hospitalization time, decreasing incidence of complication, promoting anus exhaust and incision healing, but with the relatively higher cost, ifs more applicable for patients with better economic condition.