快速流程在卵巢良性疾病腹腔镜术后的应用价值

The Applicable Value of Fast Track after Laparoscopic Surgery on the Benign Ovarian Disease

目的:探讨快速流程(FT)应用于卵巢良性疾病腹腔镜手术后的临床价值。方法:研究对象为2011年1月至2012年6月在珠海市妇幼保健院因卵巢良性疾病择期行腹腔镜手术的327例患者,按实施的不同术后管理模式分为两组,FT组168例,传统(TM)组159例,比较两组患者术后呕吐、疼痛、感染、深静脉血栓形成的发生率和首次肛门排气时间及术后住院时间。结果:FT组患者术后呕吐、疼痛和深静脉血栓的发生率均明显低于TM组(24.40%vs 39.62%、19.64%vs 61.01%和1.79%vs 8.18%),差异均有统计学意义(P<0.01)。FT组患者术后肺部感染率低于TM组(1.19%vs 3.14%),而盆腔及切口感染率高于TM组(5.36%vs 3.14%),但差异均无统计学意义(P>0.05)。与TM组比较,FT组患者术后尿路感染率明显降低(2.98%vs 8.81%),差异有统计学意义(P<0.05)。FT组患者首次肛门排气时间明显早于TM组(13.38±5.79小时vs 24.16±6.35小时),术后住院时间也较TM组明显缩短(3.85±1.62天vs 6.13±1.87天),差异均有统计学意义(P<0.01)。结论:卵巢良性疾病患者腹腔镜手术后应用FT模式具有明显的优越性,利于术后康复。

Objective：To investigate the clinical value of applying fast track（FT） after laparoscopic surgery to patients with benign ovarian diseases. Methods：According to the different postoperative management modes,327 patients with benign ovarian diseases treated by selective laparoscopic surgery in Zhuhai Maternity and Child Care Hospital from January 2011 to June 2012 were randomly divided into the FT group（168 cases） and the tra- ditional mode（TM） group（159 cases）. The incidences of vomit, pain, infection and deep venous thrombosis, and the time of first flatus and hospital stays after operation were compared between two groups. Results：The inci- dences of vomit,pain and deep venous thrombosis in the FT group were all significantly lower than those in the TM group（24. 40% vs 39.62% ,19.64% vs 61.01% and 1.79% vs 8. 18% ,P〈0.01 ）. The lung infection rate in the FT group was lower than that in the TM group（1. 19% vs 3. 14% ） ,whereas the pelvic and incision infection rates in the FT group were higher（5.36% vs 3. 14% ）, but there were no statistically significant differences（ P 〉 0.05）. Compared with the TM group,the rate of urinary tract infection was significantly lower in the FT group （2.98% vs 8.81% ,P 〈0.05）. Patients in the F-I- group had the first flatus much earlier（ 13.38 ±5.79 h vs 24. 16 ±6.35 h） and shorter hospital stays（3.85 ±1.62 day vs 6. 13 ±1.87 day） than those in the TM group （ P 〈0.01 ）. Conclusions：The FT management mode has a prominent advantage in the patients with benign o- varian disease after laparoscopic surgery,and is beneficial to their postoperative recovery.