快速康复理念在结直肠外科的临床应用探讨-外科学(普外)专业论文.docxVIP

万方数据 万方数据 3 目录 摘要 ................................................................ 5 Abstract 6 引言 ................................................................ 7 临床资料与方法 ...................................................... 8 结果 ............................................................... 10 讨论 ............................................................... 11 结论 ............................................................... 14 参考文献 ........................................................... 15 致 谢 .............................................................. 18 综述 ............................................................... 19 4 快速康复理念在结直肠外科的临床应用探讨 摘要 目的 探讨快速康复在结直肠外科围手术期中安全性、有效性及目前存在的问题。 方法 回顾性分析收治的结直肠癌手术患者的临床资料，引入快速康复理念：术 前不整夜禁食，不行机械性肠道准备，不放置鼻胃管，采取硬膜外和短效止痛药， 术后早期进食，早期下床活动。厦门市第一医院 2011 年 217 例患者（腹腔镜手术 92 例，开放手术 125 例）在快速康复外科理念指导下行结直肠癌手术，比较两组 病例术后肠梗阻、切口感染、肺部感染、吻合口漏、乳糜漏、吻合口出血等手术 后并发症的发生率，术后排气时间、术后住院时间、住院费用。 结果 两组比较处理组术后排气时间显著提前、术后并发症显著减少、术后住院 时间缩短、住院费用减少( P0．05) ，两组病人出现乳糜漏、切口感染、肺部感 染、吻合口漏等并发症发生率差异无统计学意义(P0．05).快速康复以多种新技 术新理念结合形式起到了促进结直肠癌患者术后快速康复的作用对促进外科理念 变革和提高整体质量起到积极推动作用。 结论 快速康复外科应用于结直肠癌肠手术是安全的、有效的，加快了患者的康 复，缩短了住院时间，减少了术后并发症的发生。 关键词 快速康复 腹腔镜手术 结直肠外科 5 The concept of fast track surgery applied in colorectal surgery Abstract Objective To investigate the safety and effectiveness of fast track programming in colorectal surgery . Methods Retrospective analysis of clinical data of 217 colorectal cancer patients in Xiamen First Hospital in 2011. We introduce the concept of fast track surgery:no overnight preoperative fasting, no routine mechanical bowel preparation, no routine inserting nasogastric tube, epidural anaesthesia or analgesia, early postoperative oral feeding，early ambulation.125 patients who received gastrointestinal operation and were treated with traditional ways were divied into control group(open surgery),and other 92 ones without routine ways according fast track surgery rules were divided into trial group(laparoscope s