快速康复外科理论在高龄患者腹腔镜胆囊切除术中的应用——前瞻性随机对照研究

摘要

Objective To assess the theory of fast track surgery (FTS) for patients older than 80 undergoing laparoscopic cholecystectomy (LC). Methods A total of 30 over-80-year patients received three-trocar LC in our hospital from March 2008 to March 2011. They were randomly divided into FTS and control groups. The gastrointestinal function recovery time, postoperative hospital stay, complications, and hospital cost were compared between the two groups. Results Compared with the control, FTS group showed significantly shorter gastrointestinal function recovery time [(22.9 ±5.5) h vs. ( 36. 1 ±8.1) h, t = -5. 280, P = 0.000] , shorter postoperative hospital stay [ (2. 8 ±2. 1) d vs. (5. 6 ±2.0) d, t= -3.725, P =0.000] , and less hospital cost [(9900±1800) RMB vs. (12200±2100) RMB,t= -3.231 , P =0.000]. No significant difference existed between the two groups in the rate of complications (P =0.586). Conclusion With FTS, we may reduce hospital stay and accelerate post-LC recovery for patients older than 80.%目的 探讨快速康复外科(fast track surgery,FTS)理论在高龄患者腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中的应用价值. 方法 2008年3月～2011年3月30例80岁以上择期3孔法LC,随机分为FTS组及对照组,FTS组接受FTS方案治疗,对照组接受传统方法治疗.比较2组术后肠道排气时间、住院时间、术后并发症和住院总费用等. 结果 FTS组术后排气时间(22.9±5.5)h显著短于对照组(36.1 ±8.1)h(t=-5.280,P=0.000),FTS组术后住院时间(2.8±2.1)d显著短于对照组(5.6±2.0)d(t=-3.725,P=0.000),FTS组术后住院总费用(9.9±1.8)千元显著少于对照组(12.2±2.1)千元(t=-3.231,P=0.000)；2组并发症发生率无统计学差异(P=0.586). 结论 对80岁以上患者择期LC应用FTS能缩短患者的住院时间,加速康复.