CAJ | 학술논문

目的：分析快速康复外科在上消化道穿孔手术中的临床应用价值。方法将接受上消化道穿孔修补手术的患者38例纳入观察组，进行前瞻性研究，接受围手术期快速康复外科处理。将接受上消化道穿孔修补手术的患者38例纳入对照组，进行回顾性研究，接受围手术期常规处理。比较其术后相关指标、应激指标、并发症发生率等情况差异。结果①观察组患者接受快速康复外科处理后的术后排气时间、下床时间、总住院时间均明显短于对照组患者，总住院费用少于对照组患者（ P <0.05）。②观察组患者接受快速康复外科处理后的应激指标值包括 C 反应蛋白（CRP）、降钙素原（PCT）等均明显低于对照组患者（ P <0.05）。③CRP、PCT 水平与术后排气时间、下床时间、总住院时间呈正相关。④观察组患者接受快速康复外科处理后的术后各项并发症发生率与对照组患者无明显差异（ P ﹥0.05）。结论快速康复外科应用于上消化道穿孔手术有助于优化手术效果、降低患者应激水平，且不增加术后并发症。
목적：분석쾌속강복외과재상소화도천공수술중적림상응용개치。방법장접수상소화도천공수보수술적환자38례납입관찰조，진행전첨성연구，접수위수술기쾌속강복외과처리。장접수상소화도천공수보수술적환자38례납입대조조，진행회고성연구，접수위수술기상규처리。비교기술후상관지표、응격지표、병발증발생솔등정황차이。결과①관찰조환자접수쾌속강복외과처리후적술후배기시간、하상시간、총주원시간균명현단우대조조환자，총주원비용소우대조조환자（ P <0.05）。②관찰조환자접수쾌속강복외과처리후적응격지표치포괄 C 반응단백（CRP）、강개소원（PCT）등균명현저우대조조환자（ P <0.05）。③CRP、PCT 수평여술후배기시간、하상시간、총주원시간정정상관。④관찰조환자접수쾌속강복외과처리후적술후각항병발증발생솔여대조조환자무명현차이（ P ﹥0.05）。결론쾌속강복외과응용우상소화도천공수술유조우우화수술효과、강저환자응격수평，차불증가술후병발증。
Objective To analyze the significance of fast track surgery in patients with upper gastrointestinal perforation. Methods A to-tal of 38 patients with upper gastrointestinal perforation received fast track operation were enrolled in observation group for prospective study and 38 patients with upper gastrointestinal perforation received conventional repairing operation were enrolled in control group for retrospective study. Then postoperation related indicators,stress indicators and incidence of complications were compared between these 2 groups. Results ① Postoperative discharge time,keeping bed time,total hospital stay and total hospital cost in patients with FTS in observation group were significantly lower than those of patients in control group( P < 0. 05). ② Levels of CRP and PCT in patients of observation group were significantly lower than those of patients in control group( P < 0. 05). ③Levels of CRP and PCT were positively correlated with postoperative discharge time,keeping bed time and duration for total hospital stay. ④ The difference in incidence of complications after FTS between patients of observation group and control group was not significant( P ﹥ 0. 05). Conclusion Rapid rehabilitation surgery applied to patients with gastrointestinal perforation helps to opti-mize the effect of operation and reduce the stress level of patients without increasing postoperative complications.