快速康復(fù)外科對腹腔鏡膽囊切除術(shù)患者術(shù)后并發(fā)癥及應(yīng)激狀態(tài)的影響研究

何安　孫文　林財(cái)鑫

【摘要】 目的：深入探討快速康復(fù)外科對腹腔鏡膽囊切除術(shù)患者術(shù)后并發(fā)癥以及對患者應(yīng)激狀態(tài)的臨床實(shí)際影響，為相關(guān)臨床實(shí)踐提供參考依據(jù)。方法：選取2016年1月-2017年1月本院臨床收治的腹腔鏡膽囊切除術(shù)患者138例為研究對象，采用隨機(jī)數(shù)字表法將患者分成研究組和對照組，各69例。對照組給予常規(guī)的腹腔鏡膽囊切除術(shù)治療，研究組以快速康復(fù)外科理論為指導(dǎo)，實(shí)施腹腔鏡膽囊切除術(shù)。對兩組患者應(yīng)激狀態(tài)指標(biāo)、血糖及術(shù)后并發(fā)癥發(fā)生情況進(jìn)行觀察和比較。結(jié)果：術(shù)前，兩組患者的Cor、IL-6、CRP及血糖比較，差異均無統(tǒng)計(jì)學(xué)意義（P>0.05）；術(shù)后，研究組患者的Cor、IL-6和CRP水平均明顯優(yōu)于對照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。研究組患者的血糖低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。研究組患者并發(fā)癥發(fā)生率為2.90%（2/69），明顯低于對照組的14.49%（10/69），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：快速康復(fù)外科理論應(yīng)用于腹腔鏡膽囊切除術(shù)能夠有效的控制血糖水平，降低患者術(shù)后并發(fā)癥發(fā)生率，顯著改善患者的應(yīng)激狀態(tài)，是臨床實(shí)踐的理想方式。

【關(guān)鍵詞】 快速康復(fù)外科； 腹腔鏡； 膽囊切除術(shù)； 并發(fā)癥； 應(yīng)激狀態(tài)

Study of the Effect of Rapid Rehabilitation on Postoperative Complications and Stress Status in Patients with Laparoscopic Cholecystectomy/HE An，SUN Wen，LIN Cai-xin.//Medical Innovation of China，2017，14（30）：109-111

【Abstract】 Objective：To explore the clinical effect of rapid rehabilitation surgery on postoperative complications and stress status of patients with laparoscopic cholecystectomy，and to provide reference for clinical practice.Method：138 patients with laparoscopic cholecystectomy for clinical treatment in our hospital from January 2016 to January 2017 were chosen as the research objects.The patients were randomized divided into the study group and the control group by random number table method with 69 each.The control group was treated with conventional laparoscopic cholecystectomy，the study group was treated with laparoscopic cholecystectomy under the guidance of rapid rehabilitation surgery.The stress status indices，blood glucose and postoperative complications of the two groups were observed and compared.Result：The Cor，IL-6，CRP and blood glucose of the two groups before operation were not statistically significant（P>0.05）.After the surgery，the Cor，IL-6 and CRP in the study group were significantly better than those in control group，the differences were statistically significant（P<0.05）；the blood glucose lower than the that in control group，the difference was statistically significant（P<0.05）；the complication rate of the study group was 2.90%（2/69），significantly lower than 14.49%（10/69） of the control group，the difference was statistically significant（P<0.05）.Conclusion：The application of rapid rehabilitation surgery in the practice of laparoscopic cholecystectomy can effectively control blood glucose level，reduce the incidence of postoperative complications and significantly improve the stress state of patients，is an ideal way of clinical practice.

【Key words】 Rapid rehabilitation surgery； Laparoscopy； Cholecystectomy； Complication； Stress statusendprint

First-authors address：The First Peoples Hospital of Dali，Dali 671000，China

doi：10.3969/j.issn.1674-4985.2017.30.032

臨床研究認(rèn)為，快速康復(fù)外科實(shí)際上是在患者圍術(shù)期根據(jù)患者個(gè)體的臨床差異表現(xiàn)，給予患者一系列有效的可緩解患者手術(shù)應(yīng)激狀態(tài)的臨床系統(tǒng)措施和方法[1-2]。快速康復(fù)外科的核心理念是堅(jiān)持“以患者為中心”，在患者臨床麻醉、手術(shù)操作過程以及圍術(shù)期方面給予全方位個(gè)性化舒適化的綜合干預(yù)，從而顯著提升臨床綜合效果，降低并發(fā)癥[3-4]，有效的促進(jìn)患者術(shù)后康復(fù)進(jìn)程，對于患者臨床預(yù)后的改善和生活質(zhì)量的提升意義重大[5-6]。本研究為深入探討快速康復(fù)外科對腹腔鏡膽囊切除術(shù)患者術(shù)后并發(fā)癥以及對患者應(yīng)激狀態(tài)的臨床實(shí)際影響，選取2016年1月-2017年1月本院臨床收治的腹腔鏡膽囊切除術(shù)患者138例為研究對象，針對患者相關(guān)臨床指標(biāo)進(jìn)行觀察比較，現(xiàn)報(bào)道如下。