快速康复外科理念在胰腺横断伤围手术期处理中的应用价值

Application value of fast-track surgery to perioperative management of pancreatic transection

目的探讨胰腺横断伤患者采用快速康复外科(fast-track surgery,FTS)理念指导下的围手术期处理方法的安全性、有效性。方法 27例胰腺横断伤患者依据自愿原则分为FTS组19例和对照组8例,FTS组采用FTS理念指导下的围手术期处理方法,对照组采用传统围手术期处理措施,比较2组术中吻合时间,术后1、5d血清C-反应蛋白水平,术后肠蠕动恢复时间、住院时间及术后并发症发生情况。结果 FTS组术中吻合时间((15±5)min)、术后第1、5天血清C-反应蛋白水平((70.8±8.5)、(25.4±6.6)mg/L)、术后肠蠕动恢复时间((36.0±10.5)h)、住院时间((8.0±1.5)d)与对照组((30±10)min、(80.0±13.7)mg/L、(31.9±7.7)mg/L、(54.5±12.0)h、(10.5±2.5)d)比较差异均有统计学意义(P<0.05),2组并发症发生率比较差异无统计学意义(P>0.05)。结论 FTS应用于胰腺横断伤患者围手术期安全、有效、经济,可缩短住院时间、降低治疗费用、加速术后康复。

Objective To investigate the safety and efficiency of fast-track surgery（FTS）in the perioperative management of pancreatic transection.Methods Twenty-seven patients with pancreatic transaction were divided into FTS group（n=19）receiving FTS in perioperative period,and control group（n=8）receiving traditional protocol according to the patients willing.The anastomosis time,C-reactive protein（CRP）levels on the 1st and 5th day after operation,enterocinesia recovery time,hospitalization stay,and incidence of complications were compared between two groups.Results The anastomosis time,CRP levels on the 1st and 5th day after operation,enterocinesia recovery time and hospitalization stay were（15±5）minutes,（70.8±8.5）and（25.4±6.6）mg/L,（36.0±10.5）hours and（8.0±1.5）days in FTS group,and（30±10）minutes,（80.0±13.7）and（31.9±7.7）mg/L,（54.5±12.0）hours and（10.5±2.5）days,showing significant differences between two groups（P〈0.05）.There was no significant difference in the incidence of complcaitions between two group（P〉0.05）.Conclusion FTS applied in perioperative management of pancreatic transection is safe,effective and economical.