中西医快速康复技术在阑尾切除术围手术期中的应用

The effect of integrated traditional Chinese and western medicine fast-track surgery in the perioperative period of appendectomy

目的研究中西医快速康复技术（fast-track surgery,FTS）在阑尾切除术围手术期的应用价值。方法选择2013年8月~2014年10月在我院接受阑尾切除术的118例急性阑尾炎患者作为研究对象,利用随机数字表分成对照组和实验组。对照组围手术期行传统方法处理,实验组围手术期行中西医FTS方法处理;分别评价两组的康复指标、症状、并发症、应激指标、营养指标及患者满意度。结果实验组的术后肛门排气时间较对照组快,术后住院时间较对照组短,差异均有统计学意义（P〈0.01）;两组间术后30 d内门急诊复诊次数、再入院率和再手术率的差异均无统计学意义（P〉0.05）;实验组的疼痛、失眠、口渴、饥饿、恶心呕吐及腹胀等症状均较对照组轻,差异均有统计学意义（P〈0.05或P〈0.01）;两组间并发症发生率的差异无统计学意义（P〉0.05）;术后第1天和第3天,实验组的白介素-6和C-反应蛋白均较对照组低,差异均有统计学意义（P〈0.05或P〈0.01）;术后第3天,实验组的血清白蛋白较对照组高,差异有统计学意义（P〈0.05）;实验组的患者满意度较对照组高,差异有统计学意义（P〈0.05）。结论中西医FTS技术可以有效促进阑尾炎患者术后康复、缓解患者术后症状、减轻应激反应以及增强营养支持,而且具有良好的安全性,因此获得患者更高的满意度。

Objective To study the effect of integrated traditional Chinese and western medicine fast-track surgery （FTS） in the perioperative period of appendectomy. Methods From August 2013 to October 2014, 118 patients who received open appendectomy in our hospital because of acute appendicitis were recruited and divided randomly into a control group and a experimental group. The control group was treated with routine way in perioperative period, while the experimental group was treated with integrated traditional Chinese and western medicine FTS. Meanwhile, the first flatus after operation, length of stay, times of clinic visit, readmission rate, reoperation rate, symptoms, postoperative complications, levels of IL-6, CRP and ALB, and patient satisfaction were evaluated. Results The first flatus after operation of the experimental group was earlier than that of the control group. The length of stay of the experimental group was shorter than that of the control group. There was no difference between the two groups in the times of clinic visit, readmission rate, and reoperation rate. The pain, insomnia, thirsty, starvation, nausea and vomitting, and ab- dominal distension of the experimental group were lighter than those of the control group. The level of IL-6 and CRP of the experimental group were lower that those of the control group on the first and third day after operation, while the level of ALB were higher than that of the control group on the third day after operation. The degree of satisfaction of the experimental group was higher than that of the control group. Conclusion Integrated traditional Chinese and west- ern medicine FTS in the perioperative period of appendectomy was safe, could promote recovery, reduce symptoms and operation stress, and improve nutritional support, and is more highly appreciated.