快速康复外科在肋骨骨折手术中的应用  

Fast Track Surgery in Rib Fracture Fixation

作　　者：韩志锋[1,2] 苏宜江[1,2] 李坤生[1,2] 赵润润[1,2] 沈祯云[1,2] 何绮月 卢光奎 侯广会 

机构地区：[1]南京明基医院胸外科 [2]南京医科大学附属明基医院 [3]南京明基医院麻醉科,南京210019

出　　处：《中国胸心血管外科临床杂志》2014年第1期21-24,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：南京市科技发展基金项目资助(YKK10173)~~

摘　　要：目的探讨快速康复外科(FTS)措施在肋骨骨折手术中应用的可行性和有效性。方法选取南京医科大学附属明基医院2010年10月至2013年6月肋骨骨折手术患者52例。将患者分为2组:FTS组,26例,男22例、女4例,年龄(45.62±8.20)岁;对照组,26例,男21例、女5例,年龄(46.42±7.60)岁。FTS组按照FTS方案治疗、对照组按照传统方法治疗。比较两组术后疼痛评分、胃肠功能恢复时间、术后住院时间和住院费用。结果 FTS组:术后早期6 h、24 h、48 h疼痛视觉模拟评分法(VAS)评分(4.5±0.3,4.2±0.2,3.2±0.1)均明显低于对照组(6.5±0.1,6.1±0.3,4.8±0.2),差异均有统计学意义(P<0.05);胃肠功能恢复时间:FTS组(0.8±0.2)d,明显短于对照组(1.5±0.5)d,差异有统计学意义(P<0.05);FTS组住院时间[(21.0±2.6)d vs.(26.2±3.4)d],住院总费用([5.18±0.75)万元vs.(5.78±0.64)万元]与对照组比较差异有统计学意义(P<0.05)。结论 FTS措施的应用可有效减轻肋骨骨折患者术后的疼痛,缩短住院时间,降低住院费用,促进肋骨骨折患者术后康复。Objective To investigate the feasibility and effectiveness of fast track surgery （FTS） in rib fracture fixation. Methods Fifty-two patients with chest trauma who underwent rib fracture fixation surgery in Mingji Affiliated Hospital of Nanjing Medical University from October 2010 to June 2013 were enrolled in this study. All the patients were divided into FTS group and control group. In the FTS group, there were 26 patients including 22 males and 4 females with their age of 45.62± 8.20 years, who received FTS strategies. In the control group, there were 26 patients including 21 males and 5 females with their age of 46.42±7.60 years, who received traditional treatment strategies. Postoperative visual analogue scale （VAS）, gastrointestinal function recovery time, postoperative hospital stay and hospitalization cost were compared between the 2 groups. Results VAS at 6 hours, 24 hours and 48 hours postoperatively of FTS group （4.5 ± 0.3, 4.2 ± 0.2, 3.2 ±0.1 ） were significantly lower than those of the control group （ 6.5 ± 0.1,6.1 ± 0.3, 4.8 ±0.2 ） respectively （P 〈 0.05 ）. Gastrointestinal function recovery time of FTS group （0.8± 0.2 days ） was significantly shorter than that of the control group （ 1.5±0.5 days, P 〈 0.05）. Length of hospital stay （21.0±2.6 days） and hospitalization cost （5.18±0.75 ten thousand yuan） of FTS group were significantly shorter or lower than those of the control group （26.2± 3.4 days and 5.78± 0.64 ten thousand yuan） respectively （P 〈 0.05 ）. Conclusion FTS strategies can effectively reduce postoperative VAS, shorten length of hospital stay, decrease hospitalization cost, and promote postoperative recovery of rib fracture patients.

关 键 词：快速康复外科 手术治疗 肋骨骨折 胸外伤 外科应激反应 

分 类 号：R683[医药卫生—骨科学]