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快速康复对腹腔镜胆囊切除术患者的临床效果研究
引用本文:廖作富,陈中皓,谢江,俞阳,李军. 快速康复对腹腔镜胆囊切除术患者的临床效果研究[J]. 医学临床研究, 2017, 34(2). DOI: 10.3969/j.issn.1671-7171.2017.02.038
作者姓名:廖作富  陈中皓  谢江  俞阳  李军
作者单位:上海交通大学医学院附属同仁医院普外科,上海,200336
摘    要:[目的] 探讨快速康复对腹腔镜胆囊切除术患者的临床效果.[方法] 选取2012年10月至2016年5月在本院接受治疗的180例腹腔镜胆囊切除术患者的临床资料,随机分为观察组与对照组,每组各90例.观察组采用快速康复措施,对照组采用常规的围术期措施.观察两组患者手术时间、术中出血量、术后排气时间、术后排便时间、住院时间及术后并发症.[结果] 观察组手术时间短于对照组,出血量少于对照组,但差异无统计学意义(均P<0.05);观察组术后下床活动时间、肠道排气时间、术后排便时间以及住院时间明显短于对照组,组间比较差异均具有统计学意义(P<0.05).观察组术后呕吐、腹胀、低血糖的发生率为11.11%(10/90),对照组术后并发症发生率为22.22%(20/90),观察组术后并发症显著低于对照组,差异具有统计学意义(X2=4.01,P<0.05).观察组术后低体温发生率为5.56%显著低于对照组的21.11%,差异具有统计学意义(X2=9.42,P<0.05);寒战的发生率为3.33%低于对照组的13.33%,差异具有统计学意义(X2=5.89,P<0.05).观察组术后伤口甲级愈合率明显高于对照组,丙级愈合率显著低于对照组,差异均具有统计学意义(均P<0.05).[结论] 快速康复在腹腔镜胆囊切除术中可以加速患者术后恢复,临床上值得推广.

关 键 词:胆囊切除术,腹腔镜  康复/方法  手术后期间

Application of Rapid Rehabilitation in Laparoscopic Cholecystectomy and Postoperative Recovery Influences
Abstract:[Objective]To analyze the effect of rapid rehabilitation in laparoscopic cholecystectomy and its effect on postoperative recovery.[Methods]One hundred and eighty cases of laparoscopic cholecystectomy who were treated in our hospital from October, 2012 to May, 2016 were randomly divided into observation group and control group, 90 cases in each group.In the observation group, rapid rehabilitation measures were adopted, and the control group received routine perioperative measures.The operation time, blood loss, postoperative time, postoperative defecation time, postoperative complications and hospital stay were observed.[Results]The operation time of the observation group was shorter than the control group, bleeding was less than that of the control group, but the difference was not statistically significant (P>0.05);the time of getting out of bed after surgery of the observation group, intestinal exhaust time, defecation time, postoperative hospitalization time were significantly shorter than those of the control group, the difference was statistically significant (P<0.05).postoperative vomiting, abdominal distension, the incidence of hypoglycemia of the observation group was 11.11% (10/90), the incidence of postoperative complications of the control group was 22.22% (20/90), postoperative complications in the observation group was significantly lower than the control group, the difference was statistically significant (X2=4.01,P<0.05).The incidence of postoperative hypothermia in the observation group was 5.56%, which was significantly lower than that of the control group (X2=9.42), and the difference was statistically significant (P<0.05);The incidence of chills was 3.33% ,lower than that of the control group 13.33% , the difference was statistically significant (X2=5.89,P<0.05).The incidence of hypothermia and chills in the observation group was significantly lower than that in the control group (P<0.05).The rate of wound healing in the observation group was significantly higher than that of the control group of patients, the third healing rate was significantly lower than the control group, the differences were statistically significant.[Conclusion]The rapid recovery in laparoscopic cholecystectomy can accelerate postoperative recovery, which is worthy of clinical promotion.
Keywords:Cholecystectomy  Laparoscopic  Rehabilitation/MT  Postoperative Period
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