CAJ | 학술논문

目的：探讨快速康复外科技术及精准肝切除的引入在非选择性肝切除患者中的应用价值。方法选取2009年1月至2014年1月武汉黄陂区人民医院收治的345例肝切除的手术患者，随机分为传统组及快速康复组，传统组155例，按照常规开腹手术方法以及通气后进饮食等传统围手术期治疗方案进行治疗；快速康复组190例，应用快速康复外科技术联合精准肝切除技术。对比分析两组患者术后C反应蛋白(CRP)、血皮质醇、血糖等变化以及术后离床时间、进食时间、肛门排气时间、住院天数、住院费用等指标，并观察记录不良反应及并发症。结果快速康复组手术前后皮质醇、血糖水平变化小于传统组(P<0.05)，离床时间、进食时间、肛门排气时间明显提前(P<0.05)，住院天数、住院费用少于传统组，且并未增加并发症及再入院率。结论快速康复外科技术联合精细肝切除的引入对于非选择性肝切除患者是成功且较安全的。
목적：탐토쾌속강복외과기술급정준간절제적인입재비선택성간절제환자중적응용개치。방법선취2009년1월지2014년1월무한황피구인민의원수치적345례간절제적수술환자，수궤분위전통조급쾌속강복조，전통조155례，안조상규개복수술방법이급통기후진음식등전통위수술기치료방안진행치료；쾌속강복조190례，응용쾌속강복외과기술연합정준간절제기술。대비분석량조환자술후C반응단백(CRP)、혈피질순、혈당등변화이급술후리상시간、진식시간、항문배기시간、주원천수、주원비용등지표，병관찰기록불량반응급병발증。결과쾌속강복조수술전후피질순、혈당수평변화소우전통조(P<0.05)，리상시간、진식시간、항문배기시간명현제전(P<0.05)，주원천수、주원비용소우전통조，차병미증가병발증급재입원솔。결론쾌속강복외과기술연합정세간절제적인입대우비선택성간절제환자시성공차교안전적。
Objective To investigate the effects of fast-track surgery (FTS) combined with precise liver resection for perioperative care in patients undergoing liver resection. Methods A prospective study of 345 patients undergoing FTS together with precise liver resection was performed from Jan 2009 to Jan 2014. The patients were divided randomly into traditional group and FTS group. C-reactive protein (CRP), serum cortisol, blood glucose and other blood serum index were tested. Discharging time after operation, eating time, anus exhausting time, complications, hospital stay, and hospital fee were recorded. Results FTS group had obvious less changes than control group in cortisol and blood glucose after operation (P<0.05). And the out-of-bed, eating, anus exhausting time of FTS with precise liver resection group were significantly ahead of control group (P<0.05). FTS group also had shortened hospital days, decreased hospitalization fees, and no increased complications and readmission rate. Conclusion Fast-track surgery with precise liver resection is safe and effective for recommendation of liver resection.