CAJ | 학술논문

目的：探讨快速康复外科（FTS）理念应用于胰十二指肠切除术围手术期管理的效果。方法前瞻性分析2010年7月至2014年9月深圳市第四人民医院收治的60例胰头及壶腹周围癌患者的临床资料。患者均行胰十二指肠切除术，按照随机数字表法将患者分为FTS组（30例）和对照组（30例）。FTS组采用FTS理念指导下的围手术期处理措施，对照组采用传统围手术期处理措施。结果与对照组对比，FTS 组患者手术时间更短，术中出血量更少，腹腔引流管拔除时间、术后肛门排气时间、术后住院时间更短，住院费用更少，术后1、3、5d血清C反应蛋白水平更低，肝功能恢复更快以及术后并发症发生率更低（P均＜0.05）。结论 FTS理念应用于胰十二指肠切除术术围手术期的管理安全有效，能降低患者术后应激反应，加速患者的康复进程。
목적：탐토쾌속강복외과（FTS）이념응용우이십이지장절제술위수술기관리적효과。방법전첨성분석2010년7월지2014년9월심수시제사인민의원수치적60례이두급호복주위암환자적림상자료。환자균행이십이지장절제술，안조수궤수자표법장환자분위FTS조（30례）화대조조（30례）。FTS조채용FTS이념지도하적위수술기처리조시，대조조채용전통위수술기처리조시。결과여대조조대비，FTS 조환자수술시간경단，술중출혈량경소，복강인류관발제시간、술후항문배기시간、술후주원시간경단，주원비용경소，술후1、3、5d혈청C반응단백수평경저，간공능회복경쾌이급술후병발증발생솔경저（P균＜0.05）。결론 FTS이념응용우이십이지장절제술술위수술기적관리안전유효，능강저환자술후응격반응，가속환자적강복진정。
Objective To investigate the effect of fast track surgery (FTS) principles in the perioperative management of whipple operation. Methods Sixty patients with cancer of the head of pancreas and periampullary adenocarcinoma who were admitted to the Futian People’s Hospital of Shenzhen from July 2010 to September 2014 were enrolled in this prospective study. All the patients were randomly divided into the FTS group (30 patients) and the control group (30 patients) according to the random number table. The perioperative management of patients in the FTS group was guided by the FTS principles, patients in the control group were managed with traditional methods. Results Compared with the control group, the FTS group had significantly shorter operation time, less volume of intraoperative blood loss, shorter time to drainage tube removal, shorter time to flatus, shorter duration of postoperative hospital stay, less expenses, lower serum levels of C-reactive protein on postoperative day 1, 3, 5, better recovery of hepatic function and significantly less complications (all P<0.05). Conclusion The application of FTS principle in the perioperative management of whipple operation is safe and effective, it could alleviate the post-operative stress reaction and accelerate the recovery of patients condition.