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目的探讨快速康复外科(fast-track surgery,FTS)在大范围肝切除术中应用的临床效果。方法行大范围肝切除术患者160例,实施FTS治疗80例为FTS组,传统治疗80例为对照组。比较2组围手术期相关指标及并发症发生情况。结果 FTS组补液量[(1 500±100)mL]较对照组[(2 500±200)mL]减少(P<0.05),麻醉苏醒时间[(11.25±1.62)h]较对照组[(29.68±2.14)h]缩短(P<0.05),术后进食时间[(6.15±1.21)h]、首次排气时间[(46.47±3.58)h]、首次排便时间[(68.12±3.61)h]、下床活动时间[(12.59±1.20)h]较对照组[(90.58±6.47)、(135.56±6.81)、(145.14±8.35)、(93.32±5.86)h]明显提前(P<0.01),术后住院时间[(7.89±1.25)d]较对照组[(11.54±3.62)d]缩短(P<0.01);FTS组术后肺部感染/咽喉炎发生率(1.25%)、尿路感染发生率(2.50%)、腹腔感染发生率(1.25%)、恶心/呕吐发生率(6.25%)均低于对照组(8.75%、11.25%、2.50%、20.00%)(P<0.05)。结论 FTS应用于大范围肝切除患者,可有效减少术后并发症、缩短住院时间。
Objective To investigate the clinical effect of fast-track surgery (FTS) in a wide range of hepatectomy. Methods A total of 160 patients undergoing extensive liver resection were enrolled. FTS was performed in 80 cases of FTS and 80 cases of conventional treatment were used as control. Perioperative complications and complications were compared between the two groups. Results Compared with the control group [(11 500 ± 100) mL], the amount of fluid replacement in the FTS group was significantly lower than that in the control group [(2 500 ± 200) mL] (P < (2.14 ± 3.58) h], the time of first defecation [(68.12 ± 3.61) h], the time of postprandial feeding [(6.15 ± 1.21) h] (12.59 ± 1.20 h) than those in the control group (90.58 ± 6.47), (135.56 ± 6.81), (145.14 ± 8.35) and (93.32 ± 5.86 h), respectively The length of hospital stay [(7.89 ± 1.25) d] was shorter than that of control group [(11.54 ± 3.62) d] (P <0.01). The incidence of postoperative pulmonary infection / laryngitis in FTS group (1.25%) and urinary tract infection (2.50%), incidence of abdominal infection (1.25%) and nausea / vomiting (6.25%) were lower than those of the control group (8.75%, 11.25%, 2.50% and 20.00%, P <0.05). Conclusion The application of FTS in a wide range of liver resection patients can effectively reduce the postoperative complications and shorten the hospital stay.