快速康复外科理念在肝胆外科中的应用及疗效评价

Application and efficiency of fast track surgery in hepatobiliary surgery

目的 研究快速康复外科（FTS）在肝胆外科应用的安全性及疗效.方法 我院2010年6月至2012年10月收治的肝胆外科接受不同手术治疗的98例患者随机分成实验组和对照组,对照组围手术期采用传统处理方法,实验组采用FTS围手术期处理方法,术后检测第1、3、5、7天的血清C反应蛋白（CRP）、白介素-6（IL-6）、IgA、IgG、CD4、CD8的阳性细胞值,CD4/CD8的比例,同时术后观察住院时间和术后并发症等指标.结果 实验组术后血清CRP、IL-6、IgA、IgG水平在术后第1、3、5天明显高于对照组,较对照组更快恢复术前的水平；CD4、CD8的阳性细胞值,以及CD4/CD8的比例在术后第1、3、5天明显高于对照组；而且实验组术后住院时间明显缩短,术后并发症与对照组基本一致.结论 FTS应用于肝胆外科术后患者的免疫功能恢复得更快,应激反应较低,有利于患者术后快速的康复,而且是完全安全和有效的.

Objective To investigate the efficiency and safety of the fast tract surgery （FTS）in hepatobiliary surgery.Methods The clinical data of 98 patients who underwent different hepatobiliary operations in our ward from Jun.2010 to Oct.2012 were randomly divided into control groups and FTS groups.During the perioperative period,patients in FTS groups received the improved methods while those in control groups received traditional cares.The levels of serum CRP,IL-6,IgA,IgG,CD4 and CD8 were measured on the 1 st,3rd,5th and 7th day after surgery.Hospital stay and postoperative complications were also observed after the operation.Results On the 1 st,3rd and 5th day,the levels of CRP,IL-6,IgA and IgG in the FTS group were significantly higher and returned to the preoperative level soon compared with those in the traditional group.The ratio of CD4/CD8 and the positive cells of CD3,CD4 and CD8 increased on the 1st,3rd and 5th day.The hospital stay in the FTS group reduced while the incidence of complications was almost on the same level compared with the controls.Conclusion The application of FTS in hepatobiliary operation has the advantages of faster immunologic recovery and less stress reaction.It＇s beneficial to the quick recovery of surgery patients,which is also safe and effective.