快速康复外科在胆总管结石患者围手术期中的应用  

The Application fof Fast-track Surgery in Patients with Common Bile Duct Stones

作　　者：赵冀[1] 周超[2] 邓小凡[1] 杨洪吉[1] 

机构地区：[1]四川省人民医院器官移植中心,四川成都610072 [2]四川省人民医院消化内科,四川成都610072

出　　处：《中国医药指南》2015年第18期7-9,共3页Guide of China Medicine

摘　　要：目的探讨快速康复外科理念在胆总管结石患者围手术期的应用价值。方法选择自2009年8月至2014年7月在我科住院手术的188例胆总管结石患者。2009年8月至2011年12月共60例,为对照组,采用传统围手术期处理方法;2012年1月至2014年7月共128例,为快速康复(FTS)组,采用快速康复外科理念指导围手术期处理。比较两组患者腹腔镜手术构成比,胆总管一期缝合构成比;比较两组术后下床活动时间、排气时间、进食时间、并发症发生率、住院时间、住院费用等。结果 FTS组腹腔镜手术构成比较对照组高,胆总管一期缝合手术例数较对照组更多;术后下床活动时间、排气时间、进食时间、住院天数明显缩短、住院费用明显减少(P<0.05),两组术后并发症比较无差异。结论快速康复外科理念在胆总管结石患者围手术期中的应用安全、经济、有效,具有较高的临床应用价值。Objective To investigate the feasibility, safety and economical aspects of fast-track surgery（FTS） in patients with common bile duct stones. Methods 188 cases with common bile duct stones from August 2009 to July 2014 were retrospectively studied. A total of 60 patients from August 2009 to December 2011, using the traditional perioperative protocols, is named as control group; while a total of 128 cases from January 2012 to July 2014, following FTS perioperative protocols, is FTS group. The proportion of laparoscopic surgery and primary suture of common bile duct, time of ambulation, bowel flatus and food intake after operation,length of hospital stay, total expenses and incidence of complications between the two groups were compared. Results The proportion of laparoscopic surgery and primary suture is greater in FTS group than that in cotrolled group. After surgery,the time of ambulation, bowel flatus,food intake and the length of hospital stay in FTS group were significantly shorter than those in controlled group（P〈 0.05）.Hospital expenses were also less（P〈 0.05） in FTS group;while the postoperative complications of the two groups showed no difference. Conclusions Fast- track surgery in patients with common bile duct stones is safe,feasible and economical.

关 键 词：胆总管结石 腹腔镜 胆总管一期缝合 快速康复外科 

分 类 号：R575.62[医药卫生—消化系统]