快速康复外科理念在急腹症腹腔镜探查术中的应用研究

外科研究与新技术 ›› 2015, Vol. 4 ›› Issue (1): 30-32.

快速康复外科理念在急腹症腹腔镜探查术中的应用研究

陈世钦

广东省惠州市惠东县平海镇卫生院

收稿日期:2015-04-20 修回日期:2015-04-24 出版日期:2015-03-28 发布日期:2015-04-01
通讯作者: 陈世钦 E-mail:3190424031@qq.com

A Study on the Application of Fast Track Surgery (FTS) In Acute?Abdomen

Received:2015-04-20 Revised:2015-04-24 Online:2015-03-28 Published:2015-04-01

摘要/Abstract

摘要： 目的探讨急腹症腹腔镜探查术中应用快速康复外科理念的应用研究。方法入选我院2014年3月-2015年3月接受腹腔镜手术治疗的急腹症患者300例，按随机数字表法分为对照组合治疗组，各组150例，对照组采用传统的围手术期治疗和护理，治疗组围手术期采取FTS（快速康复外科）措施，比较两组病人术前当天、术后第1、3天降钙素原（PCT）测定值变化情况；比较两组病人术后肛门排气排便时间、术后进食时间、术后静脉输液时间、住院天数、住院费用及术后并发症发生情况。结果两组术前当天PCT指标无显著差异，治疗组病人术后第1、3天降钙素原（PCT）显著优于对照组，差异有统计学意义（P<0.05）；治疗组术后肛门排气排便时间、术后进食时间、术后静脉输液时间、住院天数、住院费用等指标显著优于对照组，差异有统计学（P<0.05）；治疗组、对照组的术后并发症发生率分别为2.0%、16.0%，差异有统计学意义（P<0.05）。结论急腹症腹腔镜探查术患者进行快速康复外科措施，可提高治愈率，减少术后并发症、缩短住院时间、降低住院费用，值得临床推广。

关键词: 款速康复外科, 急腹症, 腹腔镜探查术, 基层医院

Abstract: Objective: To discuss the application of fast track surgery (FTS) in the acute?abdomen laparoscopic?exploration surgery. Methods: 300 patients of acute abdomen diseases receiving the treatment of laparoscopic exploration surgery in our hospital from March 2014 to March 2015 were divided into the control group and the treatment group by the method of random number table, with 150 patients in each group. The control group received the traditional perioperative treatment and nursing while the treatment group adopted FTS measures. PCT changes of the measured values between two groups at the same day before surgery, the first day, and the third day after surgery were compared. The duration of postoperative flatus,?bowel movement, feeding, and venous transfusion, hospital stay, hospitalization costs and postoperative complications were compared between two groups. Results: PCT indexes between the two groups on the same day before surgery were of no significant difference. The PCT of the treatment group was better than that of the control group at the first day and the third day after surgery, and the difference was of statistical significance(P <0.05). The indexes of the treatment group including the duration of postoperative flatus,?bowel movement, feeding, and venous transfusion, hospital stay, and hospitalization costs were better than those of the control group, and the difference was of statistical significance (P <0.05). The rates of postoperative complications of the treatment group and the control group were respectively 2.0% and 16.0%, and the difference was of statistical significance(P <0.05). Conclusion: When fast track surgery is applied to patients of the acute?abdomen laparoscopic?exploration surgery, the curative rate is greatly improved, the postoperative complications are reduced, the hospital stay is shortened, and the hospitalization costs are reduced. Therefore, it is worth clinical expansion.

Key words: Fast recovery surgery, Acute abdomen disease, Laparoscopic?exploration surgery, Primary hospital

陈世钦. 快速康复外科理念在急腹症腹腔镜探查术中的应用研究[J]. 外科研究与新技术, 2015, 4(1): 30-32.

参考文献

参考文献
[1] 曾雪群.快速康复护理路径在胫腓骨骨折患者中的应用效果分析[J].外科研究与新技术,2013,2(4):287-289.
[2] 李俊江,高凌.快速康复外科在急腹症手术中的应用[J].中国基层医药,2010,17 (03):309-310.
[3] 聂艳玲.快速康复外科在急腹症手术中的应用[J].中华现代护理杂志,2012,18（25）:142-146.
[4] 王红英.快速康复外科理念在急腹症围手术期护理中的应用[C].第八届全国创伤学术会议论文集,2011,9(15):217-219.
[5] 代胜云.大肠癌围术期快速康复护理的效果[J].中国实用医刊物,2014,41(22):119-120.
[6] 韩鸿彬,韩保卫,李朝辉,等.快速康复外科在胃癌患者围术期的临床应用分析[J].中国全科医学,2013,16(21):274-276.
[7] 陈平,丁国平,郑琪,等.快速康复外科理念在胃癌围手术期中的应用[J].中国普通外科杂志,2010,19 (6):155-157.
[8] 施兆文.腹腔镜联合胆道镜治疗胆结石的临床分析[J].外科研究与新技术,2014,3(1):22-23.
[9] 易淑明,郑晓妮. 快速康复外科对胃肠道手术患者围术期的作用[J].中国老年学杂志,2013,33(2):217-219.
[10] Ryska O, Serclová Z, Anto? F. [Compliance with the?procedures?of modern perioperative care (Enhanced Recovery After?Surgery) at?surgery?departments in the Czech Republic - results of a national survey] [J]. Rozhl Chir,2013,92(8):435-442.?
[11] 厉周,邓敏峰,方素珍等.快速康复外科理念在老年急腹症中的应用[J].实用医学杂志,2013,29(3):398-401.
[12] 冒维海,石书宏,陈义荣等.快速康复外科在精神患者急腹症手术中的应用价值[J].中国现代医学杂志,2014,24(14):69-71.
[13] 廖新中,黄美泰.腹腔镜在普外科急腹症诊治中的应用讨论[J].中国医学创新,2012,09(2):147-148.
[14] 张海燕,赵娟,柳臣霞等.腹膜透析急腹症并发代谢性脑病的护理体会[J].中国实用神经疾病杂志,2012,15(22):89-90.
[15] 田华.快速康复外科理念对急腹症手术患者术后康复的影响[J].实用临床医药杂志,2014,(14):54-57.
[16] 李阳,陈忠秋,郑芳等.通腑泄热法在急腹症快速康复中的应用[J].中国中医急症,2013,22(6):1011-1012.
[17] 陈世钦.快速康复外科理念（FTS）在急腹症围术期的应用探讨[J].医药前沿,2014,(20):56-57.
[18] 刘晓峰,闫清,王延文等.二级维和医院快速康复外科围术期中的麻醉管理[J].实用医药杂志,2012,29(1):19-20.
[19] 龙生,彭艺.腹腔镜在普外科急腹症诊治中的应用[J].中国实用医药,2014,(15):30-31.
[20] 张国云,何江.腹腔镜在急腹症患者中的应用[J].中国社区医师,2014,30(2):88.