实用医学杂志2012，Vol.28Issue(1)：21-24,4.DOI:10.3969/j.issn.1006-5725.2012.01.011
快速康复外科在急诊上消化道穿孔修补术中的应用
Application of fast track-surgery in the neoplasty for emergency upper gastrointestinal perforation
摘要
Abstract
Objective To investigate the safety, feasibility, and efficacy of fast track-surgery in the neoplasty for emergency upper gastrointestinal perforation. Methods Data of 62 patients with upper gastrointestinal perforation receiving neoplasty from Jan 2008 to May 2011 were retrospectively analyzed, among whom 32 patients received fast-track surgery (FTS group) and 30 patients received conventional perioperative care (conventional group). The first time of flatus and defecation, the length of hospital stay, medical cost, stress index including CRP, IL-6, and cortisol, and postoperative complications were assessed after surgery. Results The first time of flatus (2.5 d vs 4.7 d) and defecation (3.2 d vs 5.1 d), the length of hospital stay (4.5 d vs 7.8 d) in FTS group were significantly shorter, and the medical cost [ (6.5 vs 9.3) thousand yuan] were less than those in conventional group (P < 0.05). Serum levels of CRP, IL-6 , and cortisol at day 1 and 3 after surgery in FTS group were lower than those in conventional group (P< 0.05). Pulmonary complications in FTS group (1/32,3.1%) was lower than that in conventional group (5/30, 16.7% , P < 0.01), and other complication or total complications in FTS group were not significantly lower than those in conventional group (P> 0.05). Conclusion Fast-track surgery is safe, feasible, and effective in the neoplasty for emergency upper gastrointestinal perforation, and may contribute to the recovery of gut function, the reduction of hospital stay time and medical cost, and do not increase postoperative complications.关键词
消化性溃疡穿孔/快速康复外科/上消化道穿孔/急诊手术Key words
Peptic ulcer perforation/ Fast-track surgery/ Upper gastrointestinal perforation/ Emergency surgery引用本文复制引用
谢正勇,程黎阳,张玉新,赵为国,柯永莉..快速康复外科在急诊上消化道穿孔修补术中的应用[J].实用医学杂志,2012,28(1):21-24,4.基金项目
广东省自然科学基金资助项目(编号:815100100 2000010) （编号:815100100 2000010）
全军医学科研"十二五"面上课题(编号:CWS11J270) （编号:CWS11J270）
