快速康复外科理念在腹部创伤围术期的应用  

Application of fast track surgery during perioperative period in abdominal injury

作　　者：樊献军[1] 谭黄业[1] 肖咏梅[1] 马恒涛[2] 张力峰[1] 赛沙金[1] 

机构地区：[1]解放军59医院成都军区腹部外科中心,云南开远661600 [2]解放军59医院麻醉科,云南开远661600

出　　处：《解放军医学杂志》2016年第1期41-45,共5页Medical Journal of Chinese People's Liberation Army

基　　金：成都军区医学科学技术研究"十二五"课题(C12013)~~

摘　　要：目的探讨快速康复外科理念指导下的围术期处理措施应用于腹部创伤的安全性及有效性。方法选择解放军59医院腹部外科中心2011年1月-2014年12月收治的258例以单脏器或组织损伤为主的腹部创伤患者,随机分为快速康复外科组(FTS组,n=141)和对照组(n=117),FTS组采用快速康复外科理念指导下的围术期处理方法,对照组采用传统的围术期处理方法,比较两组苏醒时间,拔管时间,术前及术后第1天、第5天C反应蛋白(CRP)水平,术后乳酸清除率、排气排便时间、住院天数及住院费用、不良反应及并发症发生情况。结果 258例均治愈,与对照组相比,FTS组术后苏醒时间和拔管时间缩短,术后第1天及第5天CRP水平降低,术后乳酸清除率增高,排气排便时间、住院天数明显缩短,住院费用明显减少(P<0.05,P<0.01)。两组不良反应及并发症发生率无明显差异(P>0.05)。结论快速康复外科理念在腹部创伤围术期处理中的应用安全、有效,可加速康复进程。Objective To explore the safety and effectiveness of fast track surgery（FTS） during perioperative period in abdominal injury. Methods Two hundred and fifty-eight patients with single-organ or tissue damage of abdomen were selected from the 59 Hospital of PLA＇s Abdominal Surgery Center during Jan. 2011 and Dec. 2014. These patients were divided into FTS group（n=141） and control group（n=117）. FTS group received FTS treatment during the perioperative period, and the control group received traditional treatment. Anesthesia recovery time, extubation time, C-reactive protein（CRP） levels before and after operat ion（1st and 5th day）, postoperative lactate clearance rate, venting and defecation time, hospital stay and cost, occurrence of adverse reactions and complications were compared between the two groups. Results All the 258 patients were cured. Compared with control group, patients in FTS group got shortened anesthesia recovery time and extubation time, lower CRP levels at 1st and 5th day after operation, higher postoperative lactate clearance rate, and markedly shortened venting and defecation time and hospital stay, and the hospital cost also decreased obviously（P〈0.05, P〈0.01）. There was no remarkable difference in adverse reactions and complications（P〉0.05）. Conclusion It is safe and efficient to use FTS during perioperative period in abdominal injury, and could accelerate the recovery.

关 键 词：腹部损伤 快速康复外科 围手术期 

分 类 号：R826.65[医药卫生—临床医学]