早期功能锻炼路径在肝切除患者术后加速康复中的应用  

Application of functional exercise pathway in a enhanced recovery after surgery in patients undergoing hepatectomy

作　　者：乔晓斐[1] 荚卫东[1] 万君新 韩梅[1] 汤倩倩[1] 刘凤平[1] 周红[1] Qiao Xiaofei Jia Weidong Wan Junxin Han Mei Tang Qianqian Liu Fengping Zhou Hong.(Department of Hepatic Surgery, Anhui Provincial Hospital, Hefei 230001, China)

机构地区：[1]安徽省立医院肝脏外科,合肥230001

出　　处：《国际外科学杂志》2017年第7期473-476,共4页International Journal of Surgery

基　　金：国家自然科学基金资助项目（81172364）;安徽省科技攻关资助项目（1301042199）;安徽省卫生厅医学科研重点基金资助项目（2010A006）

摘　　要：目的探讨早期功能锻炼路径在肝切除患者术后加速康复应用中的安全性和有效性。方法选取安徽省立医院肝脏外科2014年12月-2015年8月原发性肝癌行肝切除治疗的患者共50例，根据数字表法随机分为2组，实验组（早期功能锻炼组）和对照组（传统早期活动组），每组均25例，比较两组患者术后住院时间、住院费用、并发症发病率、术后疼痛评分、术后下床活动时间和肠道通气时间。符合正态分析的计量资料以（孟±s）表示，组间比较采用t检验，计数资料比较采用，检验。结果实验组术后住院时间（7．00±2．27）d，少于对照组（9．36±4．58）d（t=3．090，P=0．003）；住院费用实验组（28184．57±8675．65）元，低于对照组（32867．26±10694．11）元（t=2．281，P=0．025）；与对照组比较，实验组患者一般并发症发病率低和总体并发症发病率更低；肠道恢复时间实验组（36．56h）早于对照组（45．24h）（均P〈0．05）。结论早期功能锻炼路径在肝切除患者术后加速康复锻炼应用中安全、有效，可以减少患者术后住院时间与住院费用，降低一般并发症发病率，加快肠道功能恢复。Objective To investigate the application value of functional exercise pathway in enhanced recovery of patients undergoing hepatectomy. Methods Fifty primary hepatic carcinoma patients who had undergone liver resection in Anhui Province Hospital from December 2014 to August 2015 were randomly divided into experimental group （ n = 25 ） and control group （ n = 25 ）. Postoperative length of hospital stay, hospitalization charges, complications, postoperative pain score, postoperative ambulation and intestinal ventilation time were compared between these groups. Measurement data with normal distribution were represented as （：~ -＋ s ） and comprison between groups was analyzed using the t test. Comparisons of count data were analyzed by the X2 test. Results Postoperative length of hospital stay of the experimental group [ （7. 00 ± 2.27 ） days ] were shorter than control group [ （ 9.36 ± 4.58 ） days ] （ t = 3. 090, P = O. 003 ） , and hospitalization expense was lower in the experimental group [ （28 184.57 ± 8 675.65） yuanJ （ t = 2. 281, P = 0. 025）. Compared with control group （40%）, the experimental group （20%） had lower overall complication ineidenee （ t = 4. 286, P = 4. 286）, and general eomplieations incidence （8%） is lower than that in control group （24%）, however, the ineidence of operation characteristic complications had not statistical significance in two groups. Besides, the intestinal recovery time in the experimental group was shorter than eontrol group （experimental group 36.56 hours, control group 45.24 hours, t = 2. 390, P = 0.019）. Conclusion The applieation of functional exercise pathway in postoperative enhanced recovery exercise of patients undergoing hepateclomy is safe and effective, which can reduce the patients＇ postoperative hospital stay, hospital eosts, and the general incidence of complications incidence, and he helpful for the intestinal function recovery.

关 键 词：功能锻炼路径 加速康复 肝切除术 有效性研究 

分 类 号：R735.7[医药卫生—肿瘤]