快速康复外科在高龄患者急性阑尾炎中的临床应用

Clinical application of fast track surgery in elderly patients with acute appendicitis

目的:评价快速康复外科(FTS)理念应用于高龄患者急性阑尾炎的临床疗效及安全性。方法:收集急性阑尾炎采取开放阑尾切除术的高龄(>70岁)患者78例,随机进行分组,其中FTS组40例,对照组38例,对照组采用传统围手术期诊疗方法,FTS组采用快速康复外科指导下的新型围手术期诊疗措施,比较两组患者术后首次排气排便时间、下床活动时间、不良反应、抗生素使用时间、住院时间、住院费用、并发症的相关情况。结果:纳入研究的78例高龄患者中,FTS组患者术后排气排便时间、抗生素使用时间、住院时间均短于传统对照组(P<0.05),住院总费用降低。两组相比较在并发症和不良反应方面差异无统计学意义(P>0.05)。结论:将FTS理念应用于高龄患者开放阑尾切除术,可促进患者术后康复,减少术后并发症,缩短住院时间,其临床疗效及安全性具有明显的优势。

Objective： To assess the clinical effect and safety of fast track surgery（FTS） approach used in elderly patients with acute appendicitis. Methods： Seventy-eight patients（〉 70 years） with acute appendicitis who underwent open appendectomy were selected and randomly divided into two groups： 40 cases in FTS group and 38 cases in control group. The control group was treated by traditional perioperative method. The FTS group was treated by FTS under the guidance of a new type of perioperative treatment. First exhaust and defecation time, leaving bed time, adverse reactions, antibiotics consumption, hospitalization time, cost of hospitalization and complications were compared between the two groups. Results： For patients in FTS group,postoperative exhaust defecation time, time of using antibiotic,hospitalization time were shorter than control group（P 〈 0.05）, and the total hospitalization costs decreased. There were no significant differences in complications and adverse reactions between the two groups（P 〉0.05）. Conclusion： The FTS approach can be applied to open appendectomy in older patients, which can promote the rehabilitation of patients, reduce the postoperative complications and shorten the hospitalization time. The clinical effect and safety of FTS have marked advantages.