快速康复外科在肝癌肝切除围手术期的应用研究

  目的  探讨快速康复外科(fast track surgery, FTS)理念在原发性肝癌肝切除围手术期应用的效果和安全性。   方法  收集福建医科大学附属第一医院115例需行肝切除的原发性肝癌患者, 随机分为FTS治疗组(FTS组)及围手术期采用传统方法治疗组(对照组), 比较两组患者术后肛门开始排气时间、开始下床活动时间、肝功能变化、术后并发症发生率、住院时间和患者总的住院费用等指标。   结果  FTS组患者术后肛门开始排气时间、开始下床活动时间显著早于对照组(P < 0.05), 肝功能恢复更快, 与对照组比较有显著性差异(P < 0.05), 术后并发症发生率、住院时间与对照组比较显著降低(P < 0.05), 总的住院费用与对照组相比减少, 但两组间无显著性差异(P > 0.05)。   结论  运用FTS理念在肝癌肝切除的围手术期治疗是安全、有效的, 术后并发症的发生率更低, 患者恢复更快, 同时可减少总的住院费用, 值得临床推广。 

Fast-track Surgical Treatment of Liver Cancer Patients through Liver Resection within the Perioperative Period

  Objective  This study aimed to investigate the effect and safety of fast-track surgery (FTS) in treating primary liver cancer (PLC) through open liver resection within the perioperative period.   Methods   A total of 115 patients with PLC who required hep- atectomy were randomly divided into two groups, namely, FTS treatment (FTS group) and traditional method treatment (control group), within the perioperative period. The following parameters were compared between the two groups: time to the start of anus deaeration, time to ambulation, liver function, postoperative complications, hospital stay, and total cost of hospitalization.   Results  The time to the start of anus deaeration and the time to ambulation were earlier in the FTS group than in the control group (P < 0.05). The recovery of liver function was faster in the FTS group than in the control group (P < 0.05). The rate of postoperative complications was lower, the hospital stay was shorter, and the total cost of hospitalization was lower in the FTS group than in the control group (P < 0.05).   Conclusion   FTS therapy for patients with PLC through hepatectomy within the perioperative period was safe and effective. The rate of complications was lower, the recovery was earlier, and the hospitalization cost was lower in the FTS group than in the control group. Thus, FTS should be considered in clinical practice.