快速康复外科理念在胰十二指肠切除术围手术期管理中的价值  

Value of fast track surgery principles in the perioperative management of whipple operation

作　　者：魏杨辉 黄耀 张卫星 杨莉涛 

机构地区：[1]深圳市福田人民医院普外科,广东省518033

出　　处：《中华临床医师杂志（电子版）》2015年第9期54-58,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：2012年广东省医学科研基金(B2012330);深圳市福田区科技计划项目(FTWS201011)

摘　　要：目的探讨快速康复外科(FTS)理念应用于胰十二指肠切除术围手术期管理的效果。方法前瞻性分析2010年7月至2014年9月深圳市第四人民医院收治的60例胰头及壶腹周围癌患者的临床资料。患者均行胰十二指肠切除术,按照随机数字表法将患者分为FTS组(30例)和对照组(30例)。FTS组采用FTS理念指导下的围手术期处理措施,对照组采用传统围手术期处理措施。结果与对照组对比,FTS组患者手术时间更短,术中出血量更少,腹腔引流管拔除时间、术后肛门排气时间、术后住院时间更短,住院费用更少,术后1、3、5 d血清C反应蛋白水平更低,肝功能恢复更快以及术后并发症发生率更低(P均<0.05)。结论 FTS理念应用于胰十二指肠切除术术围手术期的管理安全有效,能降低患者术后应激反应,加速患者的康复进程。Objective To investigate the effect of fast track surgery （FTS） principles in the perioperative management of whipple operation. Methods Sixty patients with cancer of the head of pancreas and periampullary adenocarcinoma who were admitted to the Futian People’s Hospital of Shenzhen from July 2010 to September 2014 were enrolled in this prospective study. All the patients were randomly divided into the FTS group （30 patients） and the control group （30 patients） according to the random number table. The perioperative management of patients in the FTS group was guided by the FTS principles, patients in the control group were managed with traditional methods. Results Compared with the control group, the FTS group had significantly shorter operation time, less volume of intraoperative blood loss, shorter time to drainage tube removal, shorter time to flatus, shorter duration of postoperative hospital stay, less expenses, lower serum levels of C-reactive protein on postoperative day 1, 3, 5, better recovery of hepatic function and significantly less complications （all P〈0.05）. Conclusion The application of FTS principle in the perioperative management of whipple operation is safe and effective, it could alleviate the post-operative stress reaction and accelerate the recovery of patients condition.

关 键 词：胰十二指肠切除术 胰头癌 壶腹周围癌 快速康复外科 围手术期 

分 类 号：R735[医药卫生—肿瘤]