腹腔镜结直肠切除围手术期快速康复外科流程的价值  

The value of perioperative fast track surgery program in laparoscopy colorectal resection

作　　者：江梦梅 邱赛男[1] 刘勤[1] 郭雄[1] 刘蔚东[1] 

机构地区：[1]中南大学湘雅医院肝胆肠外科,湖南长沙410008

出　　处：《中国内镜杂志》2013年第10期1045-1048,共4页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜结直肠切除手术围手术期的快速康复外科流程及其临床价值。方法回顾性分析156例腹腔镜结直肠癌切除手术患者的围手术期资料。结果制订了一套快速康复外科流程，包括术前（术前评估、肠道准备、术前置管和心理指导）、术中和术后（术后镇痛、术后营养与进食、导尿管拔除、腹腔引流管拔除、肛管拔除、功能锻炼）等临床指导方案。全部病例遵行围手术期快速康复外科流程。术后无死亡、大出血、严重肺部感染病例，吻合口瘘5例（3．2％）。术后下床活动时间为17～52h，平均27h。术后排气恢复时间为29～77h，平均39h。结论腹腔镜结直肠切除围手术期采用快速康复外科流程是可行的。[ Objective ] To explore the program of perioperative fast track surgery and its value in laparoscopy colorectal resection. [Methods] 156 cases data based on perioperative period of laparoseopy colorectal resection were analyzed retrospectively. [ Results ] A systematic program of fast track surgery was done, including preoperative care（preoperative valuation, bowel preparation, preoperative tube and preoperative psychological education）, operative care and postoperative care（analgesia, nutrition and oral feeding, early removal of catheter, abdominal drainage, anal drainage, and early mobilization）. All the cases were performed according to the fast track surgery, with no mortality, no serious bleeding and no serious pulmonary infection. The mobilization time after operation was 17-52 b （mean 27 h）. The first flatus time after operation was 29-77 h （mean 39 h）. [ Conclusion ] Perioperative fast track surgery program was feasible in laparoscopy colorectal resection.

关 键 词：结肠 直肠 腹腔镜 快速康复外科 术前准备 

分 类 号：R656.9[医药卫生—外科学] R657.1[医药卫生—临床医学]