摘要
目的探讨简化的快速康复外科策略在胃手术中应用的安全性及可行性。方法按纳入、排除及剔除标准，选取2010年3月-2011年12月连续的非急症胃部手术病例，以“信封法”随机分为快速康复外科组及传统临床路径组。对比两组的人口统计学数据、手术相关数据（手术时间、术中失血量及胃切除范围）及术后相关数据（手术后恢复情况及并发症）的差异。结果快速康复外科组（n=149）与传统临床路径组（n=154）比较，在人口统计学及手术相关数据上两组差异无统计学意义（P〉0．05）。两组在肠功能恢复时间[肠鸣音出现时间分别为（1．95±0．54）d，（2．46±0．93）d，P=0．032]、开始摄食时间[进食流质时间分别为（1．95±0．54）d，（3．53±0．61）d，P=0．013]及术后住院时间[分别为（9．63±2．14）d，（11．08±4．51）d，P=0．019]方面比较，快速康复外科组优于传统临床路径组（P〈0．05）。术后各种并发症比较（分别为吻合口出血3例 vs 5例，吻合口漏5例 vs 4例，切口感染4例 vs 3例，肺部感染9例 vs 9例，再手术0例 vs 2例，死亡1例 vs 0例），差异无统计学意义（P〉0．05）。结论简化的快速康复外科策略在胃部手术围手术处理中较传统临床路径具有在不增加术后并发症的基础上加快术后患者恢复的优势，临床应用安全、可行。
Objective To evaluate the safety and feasibility of simplified fast track surgery in gastric surgery. Methods The study enrolled consecutive cases of elective gastric surgery from March 2010 to December 2011. The patients were randomized into two groups ： simplified fast track surgery group （ n = 149） and traditional clinical pathway group （n = 154）. Demographic, intra-operative and post-operative data between two groups were compared. Results The outcome of demographic and intra-operative data between simplified fast track surgery group and traditional clinical pathway group were not different statistically （P 〉 0.05）. The time of post-operative recovery and discharge of simplified fast track surgery group was significantly shorter than traditional clinical pathway group （P 〈 0. 05 ）. Difference of post-operative complications of two groups was not significant （P 〉 0. 05 ）. Conclusion The programme of simplified fast track surgery in gastric surgery is safe and feasible.
出处
《国际外科学杂志》
2012年第11期765-769,共5页
International Journal of Surgery
关键词
临床路径
外科手术
围手术期医护
快速康复外科
Clinical pathways
Surgical procedures, operative
Perioperafive care
Fast track surgery
