中西医结合快速康复技术在消化性溃疡穿孔中的应用效果

integrated tradidonal Chinese and western medicine fast-track surgery on the perioperative Applying period of neoplasty for peotic ulcer perforation

目的探讨中西医结合快速康复技术（grs）在消化性溃疡穿孔的应用价值。方法选择2012年6月-12014年8月在我院接受穿孔修补术的消化性溃疡穿孔患者90例，随机分成对照组30例和实验组印例，对照组围术期行常规方法处理，实验组围术期行中西医结合FTS方法处理，比较两组的康复指标、症状、并发症、应激指标、营养指标及患者满意度。结果实验组患者肛门排气时间、住院时间，均低于对照组，差异有统计学意义（t值分别为-5．022，-7．172；P〈0．01）。两组术后30d内均无再入院和再手术病例；对照组的并发症发生率为25．0％，实验组为10．9％，差异无统计学意义（x2=1．824，P〉0．05）。术后第5天，两组应激指标和营养指标比较差异均有统计学意义（P〈0．05）。实验组患者满意41例，对照组16例，差异有统计学意义（Z=-2．181，P〈0．05）。结论中西医结合FTS技术在消化性溃疡穿孔的应用具有良好的安全性，可以有效促进患者术后康复、缓解患者症状、减轻应激反应以及增强营养支持，获得了患者更高的满意度。

Objective To study the effects of integrated traditional Chinese and western medicine fast- track surgery （FTS） in the perioperative period of neoplasty for peptic ulcer perforation. Methods From June 2012 to August 2014, 90 patients, who received open neoplasty caused by peptic ulcer perforation, were recruited and divided randomly into control group and experimental group. The patients of control group were treated with routine way in perioperative period, while the patients of experimental group were treated with integrated traditional Chinese and western medicine FTS. Meanwhile, the first flatus after operation, length of stay, times of clinic visit, readmission rate, re-operation rate, symptoms, postoperative complications, level of IL-6, CRP and ALB, and patient satisfaction were evaluated. Results The anus exhaust time, hospitalization time of patients in experimental group was shorter than that in control group （ t = - 5. 022, - 7. 172 ;P 〈 0. 01 ）. Both the two groups no readmission and reoperation case was found 30 d after the operation . The complication rate of the control group was 25.0% , while the experimental group was 10.9% （ x2 = 1. 824,P 〉 0. 05 ）. There was a significant difference in stress indicators and nutritional indicators between the two groups 5 days after operation （P 〈0. 05 ）. Patients in the experimental group were satisfied with 41 cases and 16 cases in the control group, the difference was statistically significant （ Z = - 2. 181, P 〈 0. 05 ）. Conclusions Integrated traditional Chinese and western medicine FTS in the perioperative period of neoplasty for peptic ulcer perforation was safe and feasible, can promote recovery, reduce symptoms and operation stress, improve nutritional support and more highly appreciated.