摘要
目的探讨快速康复外科技术(FTS)应用于小婴儿巨结肠中的可行性、安全性及临床与社会价值。方法收集本院2010年10月至2013年10月应用快速康复外科技术治疗的1-4月龄婴儿巨结肠53例,为 FTS 组;选取2008年10月至2010年10月采取传统方式治疗,与 FTS 组条件相同,总体临床特点相似的1-4月龄婴儿巨结肠40例,作为对照组。全部病例均进行一期巨结肠根治术,并获随访,随访时间6个月至5.5年;对两组病例术后首次排便时间、停止输液时间、住院时间、治疗费用和中期并发症等方面进行比较。结果FTS 组与传统组术后停止输液时间分别是(2.4±1.1)d、(3.5±1.2)d;住院时间分别是(7.4±1.2)d、(10.5±1.6)d;治疗费用分别是(8300±840)元、(11100±920)元,差异均有统计学意义(P <0.05)。两组术后首次排便时间分别是(10.3±1.8)h 和(11.5±2.4)h,第3天 CRP 正常比例分别是73.6%和55%,差异无统计学意义(P >0.05);两组术后中期效果指标(便秘、污粪/肛门失禁、肛周感染,小肠结肠炎)比较,无显著差异(P >0.05)。结论快速康复外科技术应用于1-4月龄婴儿巨结肠可明显加速患儿康复,缩短住院时间,节省住院费用,安全有效,但需要逐步推进和多部门密切配合。
Objetive To investigate the feasibility,the safety,clinical and social value of fast track sur-gery (FTS)in infants with hirschsprung 's disease.Methods From Oct 2010 to Oct 2013 Of a total of 53 in-fants (1 -4 months)were finally treated according to the fast-track protocols.The control group of 40 cases which had the same conditions,the overall clinical features similar to the FTS groups were taken traditional pro-grams from Oct 2008 to Oct 2010.All cases were executed I period of megacolon radical operation.Follow up of 6 months -5.5 years.The two groups Were compared the first defecation time,intravenous fluids stopping time,the hospitalization time,total cost of treatment and the incidence of medium-term complications.Results The FTS group compared with the control group::the intravenous fluids stopping time were 2.4 ±1.1 and 3.5 ±1.2 days respectively;the hospitalization time were 7.4 ±1.2 days and 10.5 ±1.6 days respectively;the total cost of treatment were 8 300 ±840 and 11 100 ±920 RMB respectively;the difference were statistically significant(P 〈0.05).The first defecation time were 10.3 ±1.8 hours and 11.5 ±2.4 hours respectively;the normal CRP ratio were 73.6% and 55% respectively;both no significant difference(P 〉0.05);Midterm effect index after operation in the two groups (constipation,fecal sewage /incontinence,anal infection,enterocoli-tis)had no significant difference (P 〉0.05). Conclusion The feasibility and safty of fast-track surgery in Infants with hirschsprung 's disease is excellent,with short duration of hospitalization and high comfort which need to promote the gradual and multi departments work closely with.
出处
《临床小儿外科杂志》
CAS
2014年第6期484-487,共4页
Journal of Clinical Pediatric Surgery
基金
江西省卫生厅课题,课题编号20121124.
关键词
巨结肠
外科手术
婴儿
新生
Megacolon
Surgical Procedures,Operative
Infant,Newborn