探讨加速康复外科对腹腔镜手术治疗急性阑尾炎术后康复效果及患者胃肠功能的影响

The effect of fast track surgery on postoperative rehabilitation and gastrointestinal function of patients with acute appendicitis treated by laparoscopic surgery

目的探讨对接受腹腔镜术治疗的急性阑尾炎患者行加速康复外科干预后,对其术后康复以及胃肠功能的恢复影响效果。方法60例接受腹腔镜手术治疗的急性阑尾炎患者,根据干预方案不同分成对照组(30例)与观察组(30例)。对照组接受常规腹腔镜手术治疗,观察组在围术期增加加速康复外科理念干预。对比两组术后恢复指标(首次进食时间、首次排气时间、术后1 d疼痛程度、首次排便时间、首次下床时间、住院时间)、胃肠激素指标(胃泌素、胃动素)水平、治疗安全性。结果干预后,观察组患者首次进食时间(12.09±3.11)h、首次排气时间(23.04±3.09)h、首次排便时间(26.32±2.77)h、首次下床时间(6.33±0.59)h、住院时间(4.66±0.31)d较对照组的(29.98±3.45)h、(30.77±3.65)h、(35.11±2.87)h、(18.69±1.65)h、(8.04±0.45)d更短,术后1 d疼痛程度评分(3.55±0.46)分较对照组的(5.29±0.67)分更低(P<0.05)。观察组患者胃泌素(177.48±6.87)ng/L、胃动素(265.92±7.27)ng/L较对照组的(148.77±5.55)、(154.87±6.38)ng/L更高(P<0.05)。观察组并发症发生率6.67%较对照组的46.67%更低(P<0.05)。结论对接受腹腔镜术治疗的急性阑尾炎患者行加速康复外科干预,患者术后恢复时间缩短,胃肠激素水平改善,治疗安全性更高,临床应用价值显著。

Objective To explore the effect of fast track surgery on postoperative rehabilitation and recovery of gastrointestinal function of patients with acute appendicitis treated by laparoscopic surgery.Methods 60 patients with acute appendicitis who received laparoscopic surgery were included in this study.According to different intervention schemes,they were divided into a control group(30 cases)and an observation group(30 cases).The control group received routine laparoscopic surgery,and the observation group implemented the concept of fast track surgery in the perioperative period.Comparison was made on postoperative recovery indexes(first eating time,first exhaust time,pain level 1 d after surgery,first defecation time,first time out of bed,hospitalization time),gastrointestinal hormone indexes(gastrin,motilin)level,and treatment safety between the two groups.Results After the intervention,in the observation group,the first eating time was(12.09±3.11)h,the first exhaust time was(23.04±3.09)h,the first defecation time was(26.32±2.77)h,the first time out of bed was(6.33±0.59)h,and the hospitalization time was(4.66±0.31)d,which were shorter than(29.98±3.45)h,(30.77±3.65)h,(35.11±2.87)h,(18.69±1.65)h,and(8.04±0.45)d in the control group;the pain level 1 d after surgery was(3.55±0.46)points,which was lower than(5.29±0.67)points in the control group(P<0.05).The observation group had gastrin of(177.48±6.87)ng/L and motilin of(265.92±7.27)ng/L,which were higher than(148.77±5.55)and(154.87±6.38)ng/L in the control group(P<0.05).The incidence of complications of 6.67%in the observation group was lower than 46.67%in the control group(P<0.05).Conclusion The application of fast track surgery shows significant clinical value for acute appendicitis patients treated by laparoscopic surgery,which can shorten the postoperative recovery time of patients,improve the level of gastrointestinal hormones,and has high clinical safety.