快速康复外科在手助腔镜脾切除术中的应用价值.DOCVIP

快速康复外科理念联合腹腔镜左肝叶切除术治疗 肝胆管结石的疗效观察 白东1杨福全中国医大附属盛京医院110004 摘要 目的：探讨快速康复外科理念(fast track surgery，FTS) 联合腹腔镜左肝叶切除术治疗肝胆管结石的疗效。方法：将90例肝内胆管结石集中于半肝的肝胆管结石患者分为FTS组、腹腔镜组和开放手术组，每组各30例。FTS组采用快速康复外科理念联合腹腔镜下规则性肝叶切除术；腹腔镜组采用单独腹腔镜下规则性肝叶切除术；开放手术组采用开腹规则性肝叶切除术，比较三组的手术时间、输液时间、术中出血量、住院时间、住院费用及术后并发症。结果：三组患者在术中出血量方面无明显差异，P>0.05；手术时间腹腔镜组大于开放手术组，但腹腔镜组与FTS组无明显差异，在术后住院时间、输液时间、住院费用等方面三组比较FTS组明显优于腹腔镜组和开放手术组，(P<0．05)。FTS组的术后并发症、住院费用等明显优于腹腔镜组和开放手术组，三组比较有统计学差异（P<0.05）。结论：FTS联合腹腔镜肝叶切除术治疗肝胆管结石是安全、有效的，即有腹腔镜手术微创的优势，又可减少患者的治疗费用，缩短住院时间，促进患者快速康复。 关键词：快速康复外科；腹腔镜；肝叶切除术；肝胆管结石；疗效 To observation the curative effect of fast track surgery combined with laparoscopic left hepatectomy for the treatment of Hepatolithiasis Bai Dong1 Yang Fuquan2 Shenyang Medical College affiliated Fengtian Hospital the third Department of general surgery 110024 China Medical University Shengjing Hospital 110004 Abstract 0bjective：To explore the effect of fast track surgery combined with laparoscopic hepatectomy for the treatment of Hepatolithiasis. Methods：90 cases of hepatolithiasis focused on half liver hepatolithiasis patients were divided into the FTS group, laparoscop group and Open operation group, 30 cases in each group. FTS group using fast track surgery with laparoscopic hepatectomy; laparoscopic group using separate laparoscopic regular hepatic lobectomy; open operation group using open regular hepatic lobectomy, compared three groups of operation time, the infusion time, intraoperative bleeding, hospitalization time, costs and postoperative complications. Results :The patients were intraoperative bleeding was no significant difference P>0.05；The operative time, postoperative hospital stay, the infusion time compared laparoscopic group than the control group, less than the FTS group (P <0.05). FTS group, postoperative complications, hospitalization costs are superior to laparoscopic and open operation gro