摘要
目的研究中西医快速康复技术（fast—tracksurgery，FTS）在腹腔镜胆囊切除术（1aparoscopiccholecystectomy，LC）围手术期的应用价值。方法选择2012年6月至2015年1月在我院接受Lc的150例胆囊炎患者作为研究对象。随机分成对照组、西医组和中西医组，对照组围手术期行常规方法处理，西医组行西医17FS方法处理，中西医组行中西医FTS方法处理。分别评价3组患者的康复指标、症状、应激指标、血清白蛋白（ALB）、安全指标及患者满意度。结果①康复指标：西医组术后肛门排气时间为（25．16±8．36）h，中西医组为（21．61±6．52）h，对照组为（36．06±10．88）h，西医组和中西医组均较对照组快（￡值分别为5．019、7．520，P值分别为0．000、0．000），中西医组又较西医组快（t=2．453，P=0．016）；②症状：西医组恶心呕吐及腹胀得分分别为（0．31±0．09）、（0．40±0．13）分，中西医组分别为（0．27±0．08）、（0．35±0．09）分，对照组分别为（0．35±0．11）、（0．45±0．14）分，中西医组恶心呕吐及腹胀均较西医组轻（t值分别为-2．395、-2．303，P值分别为0．018、0．023）；③IL-6、CRP和ALB：术后第1、3天，西医组与中西医组IL-6、CRP和ALB差异均无统计学意义（P〉0．05）；④安全指标：西医组并发症发生率为9．43％（5／53），中西医组为9．26％（5／54），对照组为10．71％（3／28），3组间差异无统计学意义（P〉0．05）。3组术后30天内均无再入院和再手术病例；⑤满意度：西医组和中西医组患者对治疗的总体满意度均较对照组高（Z值分别为-2．095、-2．383，P值分别为0．036、0．017），两组间差异无统计学意义（P〉0．05）。结论中西医FTS方法在Lc围手术期的应用可以有效促进患者术后康复、减轻患者症状、抑制应激反应以及维持白蛋白水平，同时具有良好的安
Objective To investigate the effect of integrated traditional Chinese （TCM） and western medicine fast-track surgery （FTS） in the perioperative management of laparoscopic cholecystect0my （LC）. Methods One hundred and fifty patients with acute cholecysititis undergoing LC from June 2012 to January 2015, were recruited and divided randomly into 3 groups. Patients in group A （ n = 30） were treated with routine method in perioperative period, patients in group B （ n = 60） were treated with western medicine FTS, and patients in group C （n = 60） were treated with integrated TCM and western medicine FTS. The first exhaust time after operation, length of stay, times of clinic visit, symptoms, levels of IL-6, CRP and ALB, postoperative complications, readmission rate, reoperation rate, and patient satisfaction were evaluated in three groups. Results The first exhaust time after operation of group B and group C was earlier than that of groupA [（25.16±8.36）h and （21.61±6.52）h vs. （36.06±10.88）h, P〈0.05], and the first exhaust time of group C was earlier than that of group B （ P 〈 0. 05 ）. The length of stay of group B and group C were shorter than that of group A [ （4.30± 1.07 ） d and （ 3.98 ± 1.16） d vs. （ 6.11 ± 1.26） d, P 〈 O. 051. The nausea and vomiting, and abdominal distension of group C were lighter than those of group B[ （0.27 ± 0.08） vs. （ 0. 31 ±0. 09） ; （0.35 ± 0. 09 ） vs. （0.40 ±0. 13 ）, respectively J. There were no difference of the level of IL-6, CRP and ALB between group B and group C [ （ 57.12 ± 16.29 ） ng/L vs. （53.91±17.15） ng/L, （53.93 ±17.18）mg/Lvs. （51.16 ±16.67）mg/L,（40.50 ±4.65）g/Lvs. （41.01 ±4.60）g/L, respectively, all P 〈0. 053. There was no difference among the three groups in the complication rate, readmission rate and reoperation rate （ all P 〉 0. 05 ）. Conclusion Integrated traditional Chinese and western medicine FTS in the perioperative period of LC can promote recovery, r
出处
《中华全科医师杂志》
2016年第2期123-129,共7页
Chinese Journal of General Practitioners
基金
浙江省中医药科技计划项目（2014ZB114）
温州市科技局项目（Y20140186）
关键词
中西医结合
胆囊切除术
腹腔镜
康复护理
Integrated traditional Chinese medicine and western medicine
Choleeystectomy, laparoscopic
Rehabilitation nursing
