胃肠手术中患者给予快速康复治疗后的疗效分析
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摘要
目的探讨胃肠手术中患者给予快速康复外科(FTS)治疗后的疗效及安全性。方法回顾性分析2012年1月至2016年1月收治的胃肠道手术患者50例,根据不同疗法分为FTS组和对照组,FTS组采用快速康复外科方法进行治疗,对照组采用传统方法进行治疗。应用SPSS 20.0进行分析,两组患者胃肠功能恢复时间、治疗前后蛋白水平、激素变化情况及肝功能指标用x±s表示,采用t检验;术后并发症采用χ~2检验,以P<0.05表示差异有统计学意义。结果与对照组相比,FTS组胃肠功能恢复时间明显缩短且差异具有统计学意义(P<0.05)。术后1个月,两组患者的总蛋白、白蛋白水平均明显降低,但FTS组患者的蛋白水平较对照组略高(P<0.05);两组患者的体内激素变化水平与治疗前相比明显降低(P<0.05);两组患者的TBIL、DBIL、ALT、AST等肝功能指标与治疗前相比明显降低(P<0.05),但FTS组的肝功能指标较对照组明显降低(P<0.05);两组患者术后情况相比,FTS组明显优于对照组且差异均有统计学意义(P<0.05)。术后并发症总发生率FTS组为7例(26.9%),对照组为14例(58.3%),FTS组优于对照组(χ~2=3.851,P<0.05)。结论快速康复治疗方案可以促进胃肠疾病手术患者功能恢复,安全性较高,可行性强,值得进行临床应用推广。
Objective To investigate the efficacy and safety of fast track surgery(FST) in patients with gastrointestinal surgery. Methods This study was retrospective included 50 patients with gastrointestinal tract operation from January 2012 to January 2016 in our hospital. 50 patients were divided into FTS group and control group by the random number table. FTS group was treated with fast track surgery,and control group was treated with the traditional method. The gastrointestinal function recovery time between two groups before and after treatment by SPSS 20. 0 statistical analysis software. The quantitative data was represented by(x± s) and analyzed by t test; The qualitative data was analyzed by χ~2test. The statistically significant difference was set as P < 0. 05. Results Compared to the control group,the recovery time of gastrointestinal function was significantly shorter in FTS group than that in control group(P < 0. 05). The level of TP and Alb were slightly lower in FTS group than control group after surgery(P < 0. 05). The level of hormone was significantly lower in two group than before surgery(P < 0. 05). The levels of TBIL、DBIL、ALT、AST and the index of liver function were significantly lower in both groups than before surgery(P <0. 05),but the index of liver function of FTS group were lower than that in control group(P < 0. 05).The postoperative condition of FTS group was better than that in control group(P < 0. 05). The incidence of postoperative complications of FTS group was lower than that in control group(26. 9% vs. 58. 3%),(χ~2= 3. 851,P < 0. 05). Conclusion Fast track surgery could promote gastrointestinal function recovery in patients with gastrointestinal diseases,It was safe and feasible,and worthy of clinical application.
Objective To investigate the efficacy and safety of fast track surgery(FST) in patients with gastrointestinal surgery. Methods This study was retrospective included 50 patients with gastrointestinal tract operation from January 2012 to January 2016 in our hospital. 50 patients were divided into FTS group and control group by the random number table. FTS group was treated with fast track surgery,and control group was treated with the traditional method. The gastrointestinal function recovery time between two groups before and after treatment by SPSS 20. 0 statistical analysis software. The quantitative data was represented by(x± s) and analyzed by t test; The qualitative data was analyzed by χ~2test. The statistically significant difference was set as P < 0. 05. Results Compared to the control group,the recovery time of gastrointestinal function was significantly shorter in FTS group than that in control group(P < 0. 05). The level of TP and Alb were slightly lower in FTS group than control group after surgery(P < 0. 05). The level of hormone was significantly lower in two group than before surgery(P < 0. 05). The levels of TBIL、DBIL、ALT、AST and the index of liver function were significantly lower in both groups than before surgery(P <0. 05),but the index of liver function of FTS group were lower than that in control group(P < 0. 05).The postoperative condition of FTS group was better than that in control group(P < 0. 05). The incidence of postoperative complications of FTS group was lower than that in control group(26. 9% vs. 58. 3%),(χ~2= 3. 851,P < 0. 05). Conclusion Fast track surgery could promote gastrointestinal function recovery in patients with gastrointestinal diseases,It was safe and feasible,and worthy of clinical application.
引文
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[9]梁伟明,黎少锋.快速康复外科应用于胃肠手术的安全性评估及个体化原则[J].现代诊断与治疗,2013,24(8):1795-1796.
[10]戴剑.胃肠手术快速康复外科的安全性对比探讨[J].浙江创伤外科,2015,20(6):1195-1196.
[2]Mark D.Porter,Bruce Shadbolt.Randomized controlled trial of accelerated rehabilitation versus standard protocol following surgical repair of ruptured Achilles tendon[J].ANZ Journal of Surgery,2015,85(5):373-377.
[3]程黎阳,谢正勇,戴观荣,等.快速康复外科应用于胃肠手术的安个性评估及个体化原则[J].实用医学杂志,2012,28(12):14-17.
[4]Satoshi Shimo OTR,Ph D,,Yuta Sakamoto PT,,Akinari Tokiyoshi MD,Ph D,et al.Early rehabilitation affects functional outcomes and activities of daily living after arthroscopic rotator cuff repair:a case report[J].Journal of Physical Therapy Science,2016,28(2):714-717.
[5]Samuel Martel,Flavia De Angelis,Emmanuelle Lapointe,et a1.Paraneoplastic neurologic syndromes:Clinical presentation and management[J].Current Problems in Cancer,2014,38(4):115-134.
[6]Jessica Judge,Beverly P.Giordano,Joan English,et al.Crohn’s Disease Masquerading as an Acute Abdomen Section Editors[J].Journal of Pediatric Health Care,2014,28(5):444-450.
[7]Alex L.Gornitzky BSa,John M.Flynn MDa,Wallis T.Muhly MDb,et al.A Rapid Recovery Pathway for Adolescent Idiopathic Scoliosis That Improves Pain Control and Reduces Time to Inpatient Recovery After Posterior Spinal Fusion[J].Spine Deformity,2016,4(4):288-295.
[8]Emily Z.Keung MD,Mark Fairweather MD,Chandrajit P.Raut MD,et al.The Role of Surgery in Metastatic Gastrointestinal Stromal Tumors[J].Curr Treat Options Oncol,2016,17(2):8-9.
[9]梁伟明,黎少锋.快速康复外科应用于胃肠手术的安全性评估及个体化原则[J].现代诊断与治疗,2013,24(8):1795-1796.
[10]戴剑.胃肠手术快速康复外科的安全性对比探讨[J].浙江创伤外科,2015,20(6):1195-1196.