快速康复外科理念在肝癌切除围手术期的应用

The application of the concept of rapid rehabilitation surgery in the perioperative period of hepatectomy for hepatectomy

目的探讨快速康复外科理念在肝癌切除术围手术期中的应用价值。方法选择高州市人民医院肝胆外科2015年1月至2017年5月收治的50例肝癌切除术患者作为研究对象。其中2015年1月至2016年3月25例作为对照组给予传统的围手术期处理,2016年4月至2017年5月25例作为观察组采用快速康复外科理念指导下的围手术期处理方法。对比两组患者术后首次排气时间、首次下床时间、住院时间,以及术后并发症发生情况、肝功能相关指标。结果观察组首次排气时间、首次下床时间、拔管时间、住院时间均短于对照组,差异有统计学意义(均P<0.05);观察组并发症发生率为8.00%,对照组为24.00%,差异有统计学意义(P<0.05);术后3 d,两组血清白蛋白、总胆红素、丙氨酸氨基转移酶相比,差异无统计学意义(P>0.05)。结论快速康复外科理念能促进肝癌切除术患者的术后康复,减少不良反应,值得临床推广应用。

Objective To explore the value of the concept of rapid rehabilitation surgery in the perioperative period of hepatectomy. Methods A total of 50 patients undergoing hepatectomy from January 2015 to May 2017 in the Department of Hepatobiliary Surgery,Gaozhou people＇s Hospital in Guangdong were selected as the subjects. From January 2015 to March 2016,25 cases were underwent traditional perioperative treatment（ the control group）,and 25 from April 2016 to May 2017（ the observation group）,with the perioperative treatment method guided by the concept of fast track surgery. The first exhaust time,the first time to get out of bed,the index of the time of hospitalization,the incidence of postoperative complications and the related indexes of liver function of the two groups were compared. Results The first exhaust time,first ambulation time,extubation time,hospitalization time in the observation group was shorter than those in the control group,the difference was statistically significant（ P〈0. 05） The complication rate of the observation group and the control group was 8% and 24%,respectively,and the difference was statistically significant（ P〈0. 05）. Three days after operation,serum albumin,total bilirubin,group two alanine aminotransferase were compared between the two groups,and the difference was not statistically significant（ P〈0. 05）. Conclusions The concept of rapid rehabilitation surgery can promote the postoperative rehabilitation of patients with hepatectomy and reduce the adverse reactions. It is worthy of clinical application.