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快速通道方案与传统方案对患者预后的影响:一项随机临床试验

Fast-track Protocol versus Conventional Protocol on Patient Outcome: A Randomized Clinical Trial.

作者信息

Iyer Sandhya P, Kareem Zeeshan

机构信息

Department of General Surgery, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.

出版信息

Niger J Surg. 2019 Jan-Jun;25(1):36-41. doi: 10.4103/njs.NJS_34_17.

Abstract

BACKGROUND

The aim of this study is to compare fast-track methodology with traditional methods of surgical care in achieving better patient outcome, and ensuring a timely discharge from the hospital, and also note the factors that are responsible for a delayed discharge from the hospital.

MATERIALS AND METHODS

One hundred patients undergoing elective surgeries were randomly allocated into fast-track and traditional protocol of perioperative care. Patients who underwent fast-track protocol (FTP) were started on early oral feeding and were encouraged for early discharge, while the others were made to follow the traditional method of recovery. The gastrointestinal functions, postoperative complications and hospital stay time were recorded. The results were tabulated and analyzed.

RESULTS

Early feeding was well tolerated by all the patients in the "fast track" group, while the patients in the control group had increased number of "nil by mouth" days, and this result was statistically significant. Ambulation was started earlier in the case group as compared to the controls, and the mean period of starting of ambulation was statistically significant, in the cases as compared to the controls. The patients in the case group had an earlier discharge from the hospital, as compared to the control group. The most common reason for a delay in discharge from the hospital, in either group, was seen to be inadequate pain relief postoperatively.

CONCLUSION

The FTP can significantly shorten the postoperative hospital stay after elective surgery, as compared to the traditional protocol.

摘要

背景

本研究的目的是比较快速康复方法与传统手术护理方法,以实现更好的患者预后,确保患者及时出院,并找出导致患者延迟出院的因素。

材料与方法

将100例行择期手术的患者随机分为快速康复组和传统围手术期护理组。接受快速康复方案(FTP)的患者早期开始经口进食,并鼓励其早期出院,而其他患者则采用传统的康复方法。记录患者的胃肠功能、术后并发症及住院时间。将结果制成表格并进行分析。

结果

“快速康复”组的所有患者对早期进食耐受性良好,而对照组患者的“禁食”天数增加,这一结果具有统计学意义。与对照组相比,病例组患者更早开始活动,且开始活动的平均时间在病例组与对照组之间具有统计学意义。与对照组相比,病例组患者更早出院。两组中导致延迟出院的最常见原因均为术后疼痛缓解不足。

结论

与传统方案相比,FTP可显著缩短择期手术后的住院时间。

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