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快速康复外科联合中医治疗在肝硬化门静脉高压症去血管化手术中的临床应用

Clinical application of fast-track surgery with Chinese medicine treatment in the devascularization operation for cirrhotic portal hypertension.

作者信息

Wei Yang-nian, Li Nian-feng, Cai Xiao-yong, Lu Bang-yu, Huang Fei, Mo Shi-fa, Zhang Hong-chang, Wang Ming-dong, Wu Fa-sheng

机构信息

Xiangya Hospital of Central South University, Changsha, 410008, China.

Hepatobiliary Gland Surgery of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530011, China.

出版信息

Chin J Integr Med. 2015 Oct;21(10):784-90. doi: 10.1007/s11655-015-2317-9. Epub 2015 Nov 3.

Abstract

OBJECTIVE

To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices.

METHODS

Seventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group (fast-track surgery combined with Chinese medicine treatment) using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period.

RESULTS

Compared with the conventional group, the fast-track group had longer operation time (253.6±46.4 min vs. 220.6±51.0 min) and anesthesia recovery time (50.5±15.9 min vs. 23.5±9.6 min; P<0.01); less bleeding (311.3±46.8 mL vs. 356.2±57.5 mL; P<0.01) and less transfusion (1932.3±106.9 mL vs. 2045.6±115.4 mL; P<0.01); as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred.

CONCLUSION

Fast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.

摘要

目的

探讨快速康复外科联合中医治疗在肝硬化食管静脉曲张断流术中的临床效果。

方法

选取2009年1月至2013年6月收治的72例肝硬化食管静脉曲张患者,采用随机数字表法随机分为传统组和快速康复组(快速康复外科联合中医治疗),每组36例。记录并比较两组患者围手术期的手术及麻醉恢复时间、术后住院时间和生活质量。

结果

与传统组相比,快速康复组手术时间较长(253.6±46.4分钟对220.6±51.0分钟),麻醉恢复时间较长(50.5±15.9分钟对23.5±9.6分钟;P<0.01);出血量较少(311.3±46.8毫升对356.2±57.5毫升;P<0.01),输血量较少(1932.3±106.9毫升对2045.6±115.4毫升;P<0.01);胃肠功能恢复较快,术后住院时间较短,生活质量较高。术后无严重并发症发生,无再出血情况。

结论

快速康复外科联合中医治疗是一种安全可行的方法,可加速肝硬化门静脉高压症患者断流术围手术期的康复。

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