快速康复外科理念对门脉高压症患者门奇断流术后并发症发生的影响

目的 探讨快速康复外科（FTS）理念在乙肝肝硬化门脉高压症患者脾切除门奇断流术围手术期中应用的安全性.方法 选择2009年1月～2013年6月在本院普外科住院,接受脾切除门奇静脉断流的乙肝肝硬化门脉高压症患者187例,随机分为FTS组97例及对照组90例.对照组采用传统的围术期诊疗方法,FTS组采用快速康复的新型围术期干预措施;采集不同组间患者围手术期并发症发生、住院时间、输液总量、白蛋白及血浆输入总量、首次排气及排便时间、肝功能恢复正常时间等指标,统计分析两组间术后并发症发生及相关指标差异,以评估FTS在乙肝肝硬化门脉高压症患者脾切除门奇断流术围手术期诊疗中应用的安全性.结果 FTS组的患者肺部感染、切口并发症、胃肠道并发症及腹水发生率均较对照组明显较少,差异显著,有统计学意义（P＜0.05）.术后肛门排气及排便时间提前,术后白蛋白及血浆输入总量、术后补液总量明显减少,术后住院时间缩短,差异显著,有统计学意义（P＜0.05）.结论 在乙肝肝硬化门脉高压症患者脾切除门奇断流术围手术期中应用FTS理念是安全、有效的,对促进患者康复具有显著意义.

Influence of FTS concept on postoperative complications of patients undergoing Pericardial devascularization with Portal hypertension

Objective To investigate the safety of FTS in perioperative therapy on postoperative complications of patients un- dergoing Pericardia1 devascularization with Portal hypertension. Methods 187patients with Portal hypertension from Jan 2009 to Jun 2013 were divided into the FTS group （n = 97） and the control group （n = 90）. The FTS group underwent the perioperative curing in- tervention according to the new measuremen pattern,while the control group was given the routine curing. Timely collection of the relat- ed indicators of efficacy and safety performed well. Results FTS group of patients with pulmonary infection, incision complications, gastrointestinal complications and the incidence of ascites were all significantly less, the difference was statistically significant （P 〈 0. 05）. FTS Group in advance of the anal vent and defecation time, postoperative albumin and plasma input and the total infusion was significantly reduced, postoperative hospitalization time was significantly shortened, the difference was statistically significant （P 〈 0. 05 ）. Conclusion The application of FTS concept is safe and effective in perioperative therapy of Patients with Portal hypertension, and it can significantly promote the rehabilitation.