快速康复外科理念在行急诊无张力疝修补术的腹股沟嵌顿疝患者中的应用

目的探讨快速康复外科（fast track surgery，FTS）理念在行急诊无张力疝修补术腹股沟嵌顿疝患者中的应用效果。 方法选取2016年2月至2017年10月，丹阳市人民医院收治的132例腹股沟嵌顿疝患者为研究对象，随机分为研究组（66例）与对照组（66例）。2组均行急诊无张力疝修补术，对照组给予围手术期常规干预，研究组给予FTS理念的系统干预，术后均随访6个月。比较2组术后胃肠道功能恢复时间、急慢性疼痛、并发症及应激反应方面的差异。 结果研究组术后肠鸣音恢复时间、肛门排气时间、进食时间、下床活动时间和住院时间较对照组缩短，差异有统计学意义（P<0.01）。与对照组比较，研究组术后第2天NRS评分及术后1个月IPQ评分均降低，差异有统计学意义（P<0.01）。术后随访期间，研究组并发症总发生率及腹股沟不适感发生率低于对照组，差异有统计学意义（P<0.05）。 结论FTS理念的系统干预可加速行急诊无张力疝修补术的腹股沟嵌顿疝患者预后，促进其胃肠功能恢复，减轻患者疼痛程度，降低患者术后并发症及腹股沟不适感的发生率。

Application of fast track surgery concept in incarcerated inguinal hernia patients undergoing emergency tension-free hernia repair

ObjectiveTo investigate the application effect of the fast track surgery (FTS) concept in incarcerated inguinal hernia patients undergoing emergency tension-free hernia repair. Methods132 cases of incarcerated inguinal hernia patients admitted to Danyang City People's Hospital were selected as the research objects, which were randomly divided into the study group (n=66) and the control group (n=66), emergency tension-free hernia repair was performed in the 2 groups, the control group was given routine perioperative intervention, the study group was given systematic interventions based on the concept of FTS. All patients were followed up for 6 months. Postoperative gastrointestinal function recovery time, acute and chronic pain, complications, and stress responses in the 2 groups were compared. ResultsThe postoperative bowel sounds recovery time, anal exhaust time, feeding time, ambulation time and hospital stay in the study group were shorter than those in the control group (P<0.01). Compared with the control group, the NRS score on the second day after operation and IPQ score at 1 month after operation of the study group decreased (P<0.01). During the follow-up period, the incidence of complication and groin discomfort in the study group were lower than that in the control group (P<0.05 or P<0.01). ConclusionSystematic interventions based on the concept of FTS can accelerate the recovery of gastrointestinal function of incarcerated inguinal hernia patients undergoing emergency tension-free hernia repair, reduce the degree of pain and the incidence of postoperative complications and groin discomfort.