作　　者： (曹永丽）; (王文航）; (杨维维）; (张文丽）; (魏东）;

机构地区： 解放军150中心医院全军肛肠外科研究所,洛阳471031

出　　处： 《中华结直肠疾病电子杂志》 2017年第4期345-348,共4页

摘　　要： 目的探讨快速康复外科(FTS)在腹腔镜结肠次全切除逆蠕动盲直肠吻合术治疗慢传输型便秘(STC)围手术期护理的应用前景。方法将2012年1月到2013年6月入住全军肛肠外科研究所的54例接受腹腔镜结肠次全切除逆蠕动盲直肠吻合术的STC患者,其中26例患者采用快速康复外科的围手术期护理方法,设为观察组,28例患者采用传统围手术期护理方法,设为对照组,比较两组患者术后肛门首次排气排便时间、术后进食时间、住院时间、体质量变化、住院治疗费用以及胃肠生活质量评分(GIQLI)和便秘评分(WCS)的改善。结果观察组与对照组相比,术后首次肛门排气排便时间早于对照组(t=6.882,P<0.05),进食时间(t=4.916,P<0.05)及住院时间缩短(t=9.216,P<0.05),体质量下降小于对照组(t=10.021,P<0.05),住院治疗费用少于对照组(t=4.763,P<0.05),以上各项差异均有统计学意义(P<0.05)。术后1个月观察组GIQLI(t=-2.011,P<0.05)和WCS(t=2.150,P<0.05)优于对照组。结论采用快速康复围手术期护理结合腹腔镜结肠次全切除逆蠕动盲直肠吻合术治疗STC,术后早期得到了快速康复,改善了患者早期的生活质量,具有很好的应用价值和前景。 Objective To investigate the perioperative application prospect of fast-track surgery（FTS）in laparoscopic subtotal colectomy with antiperistalsis cecorectal anastomosis treatment for colonic slow transit constipation（STC）. Methods Fifty-five patients received subtotal colectomy withantiperistalsis cecorectal anastomosis treatment from January 2012 to June 2013 were divided into observation group and Control group. Twenty-eight patients of the control group were received routine care and guidance in the perioperative. Twenty-six patients of the observation group were received FTS treatment in the perioperative. The perioperative changes of body weight, the first exhaust time, the time to begin eating, the postoperative hospital stay, the hospitalization expenses and the clinical curative effect were compared between the two groups. Results The first exhaust time（t=6.882, P〈0.05）、the time for eating（t=4.916, P〈0.05）and the postoperative hospital stay（t=9.216, P〈0.05） in the observation group was shorter compared with the control group. The weight loss in the observation group than that of the control group（t=10.021, P〈0.05）, The hospitalization expenses are fewer in the observation group than that of the control group（t=4.763, P〈0.05）,. One months after operation, the gastrointestinal quality of life index score（t=-2. 011, P〈0.05） and WCS（t=2.150, P〈0.05） in the observation group were better than those in the control group. Conclusion The postoperative curative effect of laparoscopic subtotal colectomy with antiperistaltic cecoproctostomy combined the perioperative nursing of fast track surgery was obvious, with good application value and prospect.

关 键 词： 便秘 快速康复外科 腹腔镜结肠次全切除逆蠕动盲肠直肠吻合术 慢传输型便秘