快速康复外科护理在腹腔镜胆总管切开取石一期缝合术中的应用效果分析

Analysis on the effect of the application of fast track surgery care in the laparoscopic common bile duct exploration and primary suture of bile duct

目的 探讨快速康复外科（FTS）护理理念在腹腔镜胆总管切开取石一期缝合术（LBEPS）中的应用效果.方法 将150例择期行LBEPS患者根据住院号随机分为2组,每组各75例.2组患者均接受同一组手术医师行腹腔镜胆总管切开取石一期缝合术,观察组围手术期采用FTS护理,对照组采用常规护理.对2组临床指标（住院总时间、住院总费用、术后腹腔引流管留置时间、导尿管留置率）及术后第7天实验室指标（总蛋白、血液白蛋白、总胆红素、丙氨酸转氨酶）进行比较.结果 与对照组相比,观察组在住院总费用、住院总时间、术后腹腔引流管留置时间和导尿管留置率均低于对照组,差异有统计学意义（P〈0.05）;观察组的血液白蛋白、总蛋白指标均显著高于对照组,而总胆红素、丙氨酸转氨酶水平显著低于对照组（P〈0.05）.结论 快速康复外科理念在LBEPS患者中的应用具有良好的安全性和有效性,可缩短术后腹腔引流管留置时间,降低导管留置率,缩短住院天数,减少住院总费用;可提高患者术后免疫及肝功能,使患者康复加速,减少患者的痛苦.

Objective To explore the effect the of application of the fast track surgery （FTS） care concept in the laparoscopic common bile duct exploration and primary suture （LBEPS）.Methods A total of 150 patients scheduled to receive LBEPS were randomly divided into two groups according to the hospitalization number,with 75 cases in each group.All patients received the laparoscopic surgeons choledocholithotomy a suture conducted by the same set of doctors.The observation group was given FTS during perioperative care,while the control group received routine care.The clinical parameters （total hospital stay,total cost of hospitalization, postoperative abdominal drainage tube indwelling time,catheterization rate,etc） and laboratory parameters after 7 days＇ after operation （total protein,serum albumin,total bilirubin,alanine transaminase） of the two groups was compared.Results The total cost of hospitalization,total hospital stay,postoperative abdominal drainage tube indwelling catheter indwelling time of the observation group were lower than that of the control group,and the differences were statistically significant （P〈0.05）.The serum albumin,total protein on laboratory indexes of the observation group were significantly higher than that of the control group,and the total bilirubin,propionic Valley aminotransferase levels of the observation group were significantly lower than that of the control group （P〈0.05）.Conclusion The application of fast track surgery in LBEPS patients was shown good safety and efficacy,which can shorten the indwelling time of the postoperative abdominal drainage tube,reduce the indwelling rate,shorten hospital stay and reduce the total cost of hospitalization,and meanwhile it can improve postoperative liver immunity function,so as to accelerate the recovery of patients and reduce the suffering of patients.