胃肠手术快速康复外科治疗优化设计方案的临床研究  

CLINICAL RESEARCH ON THE OPTIMIZED DESIGN SCHEME OF FAST-TRACK SURGICAL TREATMENT IN GASTROINTESTINAL SURGERY

作　　者：颜冰[1] 韩伟[1] 张志哲[1] 周瑞仁[1] 李新萍[1] 陆春秀[1] 林桦[1] 孙兴[1] 谢丽娟[1] 冯关荣[1] 苏泽[1] 黄敏红[1] 许国定[1] 黄江明[1] 

机构地区：[1]广西医科大学附属南宁市第一人民医院普外科,南宁530022

出　　处：《广西医科大学学报》2012年第5期694-697,共4页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No.2010GXNSFA013261)

摘　　要：目的:探讨胃肠手术应用快速康复外科(FTS)优化设计方案治疗的安全及可行性。方法:选取施行胃肠道手术患者194例,随机分组:快速康复外科组(治疗A组)60例;微波照射治疗结合快速康复外科组(治疗B组)73例;传统手术组(对照C组)61例,比较3组病例的各项临床指标和实验室指标。结果:3组患者的手术时间、术中出血量、出现急性胃扩张而需要重置胃肠减压管并禁食和吻合口漏方面无明显差异(P>0.05);A组与C组在切口感染和肺部感染方面无明显差异(P>0.05),在术后肛门恢复排气时间、体重减轻、术后停输液时间、切口愈合时间、术后住院时间、治疗费用、恶心呕吐、咽喉疼痛和尿路感染等方面明显减少(P<0.01);A组与B组在术后停输液时间、术前和术后1周的体重差无明显差异(P>0.05),B组较A组在术后肛门恢复排气时间、切口愈合时间、术后住院时间、恶心呕吐、咽喉疼痛、肺部感染和治疗费用方面明显减少(P<0.01),切口感染也减少(P<0.05)。结论:胃肠手术患者的快速康复外科治疗是一种全新外科理念,较传统手术治疗有明显优势。采用微波照射治疗结合快速康复外科治疗的优化方案更有利于患者的术后康复,是安全、可行的治疗方法之一。Objective：To study the safety and feasibility of the optimized design scheme of fast-track surgical treatment in gastrointestinal surgery. Methods：A total of 194 patients undergoing gastrointestinal surgery were randomly divided into 3 groups： 60 cases with the fast-track surgical （group A）, 73 cases with the microwave irradiation add fast-track surgical （group 13）, and 61 cases with the traditional operation （group C）. The clinical and laboratory data of the three groups were compared. Results： The operation time and the bleeding amount during the operation, the complication rate of anastomotic leakage, need to reset the gastrointestinal decompression tube and fasting because of the acute gastric dilatation among the 3 groups were not different （ P 〉0.05）. There was also no difference in incision infection and lung infection between groups A and C （ P 〉0.05）. But there were decreased significantly on the postoperative anus exhaust time, loss of weight and the time of discontinuing intravenous infusion after operation, wound healing days, postoperative hospital stay, treatment cost, nausea vomiting, throat pain, and urinary tract infection etc. in group A （ P 〈0.01）. There were no differences in the time of discontinuing intravenous infusion after operation, the weight difference before and after operation 1 week between groups A and B （ P〉0.05）. The complication of the postoperative anus exhaust time, wound healing days, postoperative hospital stay, nausea vomiting, throat pain, lung infection and treatment cost were decreased significantly in group B than those in group A （ P 〈0.01）, also in the incision infection （ P 〈0.05）. Conclusion：The fast-track surgical treatment in gastrointestinal surgery is an all-new surgical concept, it has obvious advantages than traditional operation. It was more favorable for postoperative rehabilitation by using the microwave irradiation add fast-track surgical, and is one of the safe and feasible treatment.

关 键 词：快速康复外科 微波照射治疗 胃肠手术 

分 类 号：R656.6[医药卫生—外科学]