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编号:12139984
快速康复外科在腹腔镜胆总管探查手术中的应用体会(1)
http://www.100md.com 2011年3月1日 罗洁 王春华 张伟 李敏 李毅
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     (遂宁市中心医院肝胆外科 四川 遂宁 629000)

    【摘要】目的:探讨快速康复外科(Fast Track Surgery)在腹腔镜胆总管探察手术(LCBDE)的应用效果。 方法:遂宁市中心医院肝胆外科2009年6月~2011年2月对97例胆总管结石患者施行腹腔镜胆总管探察术,按治疗小组为单位分为两组:第一组(n42)采用四孔法腹腔镜手术和传统方式进行围手术期处理, 第二组(n55)采用三孔法腹腔镜手术并运用快速康复外科理念指导围手术期处理。比较两组术后恶心、呕吐发生率,术后12小时疼痛程度,首次进食时间,下床活动时间,排气、排便时间,住院天数以及住院总费用。结果:97例手术均获成功,无严重术后并发症。两组术后恶心、呕吐发生率,术后12小时疼痛程度,首次进食时间,下床活动时间,排气、排便时间,住院天数以及住院总费用比较差别均有统计学意义(P<0.05)。结论:快速康复外科理念能够减轻腹腔镜胆总管探察术后并发症,促进患者更快康复,降低住院费用,具有安全性和可操作性。

    【关键词】快速康复外科;腹腔镜胆总管探察;胆总管结石

    The using experience of fast track surgery in laparoscopic commom bile duct exploration

    Luo JIe Wang Chunhua Zhang Wei Li Min Li Yi

    【Abstract】 Objective: To evaluate the effects of Fast Track Surgery in laparoscopic commom bile duct exploration. Methods: During the period between June 2009 and February 2011, 90 common duct stone patients were performed exploration surgery of LCBDE in the department of hepatobiliary surgery in Suining Central hospital. The patients were classified into two groups. 42 of them were classified to group one, which were subjected to 4-holes Laparoscopic surgery with traditional ways of perioperative period. while 55 of them were classified to group two,which were subjected to 3-holes Laparoscopic surgery and were treated under the guidance of Fast Track Surgery in perioperative period. After surgery, The incidence of nausea and vomits, ache level after 12 hours, first foodtake time, out-of–bed activity time, fart and defecate time, hospital day and hospital cost were compared between the two groups. Results: All the 97 surgeries were successful and no postoperative complications occurred.All the indexes described had statistical significance (P<0.05). Conclusions: Fast Track Surgery can relieve the postoperative complications of the exploration surgery of biliary tract under abdominoscope, promote the recovery of patient, and cut down the cost of hospital.It is safe and reliable.

    【Keyword】 Fast Track Surgery;LCBDE; common duct stone.

    【中图分类号】R657.4【文献标识码】A【文章编号】1008-6455(2011)06-0002-02

    随着腹腔镜技术在肝胆外科的运用,其微创的优势的到医患双方的高度认可,腹腔镜技术也不仅仅局限于腹腔镜胆囊切除(LC),腹腔镜胆总管探察(LCBDE)也在临床上广泛运用[1] ......

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