CAJ | 학술논문

目的探讨快速康复外科(FTS)在活体肝移植供者择期手术中的临床价值.方法回顾性分析2006年1月至2011年11月上海交通大学附属仁济医院收治的214例肝移植供者的临床资料,根据手术处理方法分为传统组和快速组.传统组:73例,2006年1月至2009年5月采用传统围手术期处理方案；快速组:141例,2009年5月至2011年11月采用FTS方案.观察比较两组供者术后康复情况,计数资料比较采用x2检验,计量资料比较采用t检验.结果快速组供者手术时间、下床活动时间、肛门排气时间、排便时间、术后住院时间、住院费用分别为(178±37) min、(1.6±1.0)d、(2.9±1.6)d、(3.1±1.5)d、(5.9±1.9)d、(1.8±0.6)万元,传统组供者相应指标分别为(167±33) min、(3.6±1.4)d、(4.6±2.3)d、(4.5±1.4)d、(7.6±1.5)d、(2.2±0.4)万元,两组比较,差异有统计学意义(t =2.115,77.138,6.504,6.913,6.970,73.038,P＜0.05)；而快速组和传统组术中出血量分别为(130±47)ml和(138±46) ml,两组比较,差异无统计学意义(t=1.251,P＞0.05).快速组和传统组供者满意率分别为98.6％(139/141)和89.2％(74/83),两组比较,差异有统计学意义(x2=9.94,P＜0.05).结论 FTS在活体肝移植供者中应用安全、经济,能够减少手术应激反应,促进供者早日康复,降低住院费用,具有较高的临床应用价值.
목적 탐토쾌속강복외과(FTS)재활체간이식공자택기수술중적림상개치.방법 회고성분석2006년1월지2011년11월상해교통대학부속인제의원수치적214례간이식공자적림상자료,근거수술처리방법분위전통조화쾌속조.전통조:73례,2006년1월지2009년5월채용전통위수술기처리방안；쾌속조:141례,2009년5월지2011년11월채용FTS방안.관찰비교량조공자술후강복정황,계수자료비교채용x2검험,계량자료비교채용t검험.결과 쾌속조공자수술시간、하상활동시간、항문배기시간、배편시간、술후주원시간、주원비용분별위(178±37) min、(1.6±1.0)d、(2.9±1.6)d、(3.1±1.5)d、(5.9±1.9)d、(1.8±0.6)만원,전통조공자상응지표분별위(167±33) min、(3.6±1.4)d、(4.6±2.3)d、(4.5±1.4)d、(7.6±1.5)d、(2.2±0.4)만원,량조비교,차이유통계학의의(t =2.115,77.138,6.504,6.913,6.970,73.038,P＜0.05)；이쾌속조화전통조술중출혈량분별위(130±47)ml화(138±46) ml,량조비교,차이무통계학의의(t=1.251,P＞0.05).쾌속조화전통조공자만의솔분별위98.6％(139/141)화89.2％(74/83),량조비교,차이유통계학의의(x2=9.94,P＜0.05).결론 FTS재활체간이식공자중응용안전、경제,능구감소수술응격반응,촉진공자조일강복,강저주원비용,구유교고적림상응용개치.
Objective To investigate the clinical value of fast track surgery (FTS) in donor in liver transplantation.Methods The clinical data of 214 donors for liver transplantation at the Renji Hospital of Shanghai Jiaotong University from January 2006 to November 2011 were retrospectively analyzed.All donors were divided into FTS group and conventional group.From January 2006 to May 2009,73 donors who received conventional perioperative management were in the conventional group,and 141 donors who received FTS from May 2009 to November 2011 were in the FTS group.The recovery of the donors in the 2 groups was compared.All data were analyzed using the chi-square test or t test.Results The operation time,time to out-of-bed activity,time to postoperative exsufflation,time to bowel movement,and duration of postoperative hospital stay were (178 ±37) minutes,(1.6 ± 1.0) days,(2.9 ± 1.6) days,(3.1 ± 1.5) days and (5.9 ± 1.9) days in the FTS group,which were significantly shorter than (167 ± 33) minutes,(3.6 ± 1.4) days,(4.6 ± 2.3) days,(4.5 ± 1.4) days and (7.6 ± 1.5) days in the conventional group (t =2.115,77.138,6.504,6.913,6.970,P ＜ 0.05).The hospital costs of the FTS group and the conventional group were (1.8 ±0.6) × 104 yuan and (2.2 ±0.4) x 104 yuan,respectively,with a significant difference between the 2 groups (t =73.038,P ＜ 0.05).The volumes of operative blood loss of the FTS group and the conventional group were (130 ± 47)ml and (138 ± 46)ml,with no significant difference between the 2 groups (t =1.251,P ＞ 0.05).The rate of satisfaction of the donors in the FTS group and conventional group were 98.6％ (139/141) and 89.2％ (74/83),respectively,with a significant difference between the 2 groups (x2 =9.94,P ＜ 0.05).Conclusion FTS is safe,economical and can reduce stress,decrease hospital costs and promote early recovery of donors in liver transplantation.