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中华普外科手术学杂志(电子版)

中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (02) : 203 -205. doi: 10.3877/cma.j.issn.1674-3946.2019.02.029

所属专题： 文献；

论著

快速康复外科在小儿无并发症的炎性阑尾切除术后恢复中的疗效分析
曹闯1,†(), 吴江1, 黄庆荣1, 徐飞鹏2, 王波1   
  1. 1. 524000　广东湛江，广东医科大学附属医院小儿外科
    2. 524000　广东湛江，广东医科大学附属医院胃肠外科
  • 收稿日期:2018-05-23 出版日期:2019-04-26
  • 通信作者: 曹闯

Efficacy of Fast-track surgery for uncomplicated appendicitis in children

Chuang Cao1,†(), Jiang Wu1, Qingrong Huang1, Feipeng Xu2, Bo Wang1   

  1. 1. Department of Pediatric Surgery, Affiliated Hospital of Guangdong Medical College, ZhanJiang, GuangDong 524000
    2. Gastrointestinal Surgery, Affiliated Hospital of Guangdong Medical College, ZhanJiang, GuangDong 524000
  • Received:2018-05-23 Published:2019-04-26
  • Corresponding author: Chuang Cao
  • About author:
    Corresponding author: Cao Chuang, Email:
  • Supported by:
    Zhanjiang non-funded science and technology research project(Zhan ke ( 2017 ) 83——2017 b101)
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曹闯, 吴江, 黄庆荣, 徐飞鹏, 王波. 快速康复外科在小儿无并发症的炎性阑尾切除术后恢复中的疗效分析[J]. 中华普外科手术学杂志(电子版), 2019, 13(02): 203-205.

Chuang Cao, Jiang Wu, Qingrong Huang, Feipeng Xu, Bo Wang. Efficacy of Fast-track surgery for uncomplicated appendicitis in children[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(02): 203-205.

目的

探讨快速康复外科(FTS)在小儿无并发症阑尾切除手术后恢复中的疗效。

方法

回顾分析2014年6月至2017年12月收治的阑尾炎患者，选取无并发症且接受FTS诊治的患者102例为FTS组，从接受传统围术期治疗的患者中选取102例匹配作为传统组。应用统计软件SPSS24.0对数据进行分析。术后抗生素及镇痛类药物用量及使用人次以(±s)表示，采用独立t检验；24 h出院率、并发症率采用χ2检验，P<0.05时差异有统计学意义。

结果

FTS组患者的术后住院时间、总住院时间、明显短于传统组，24 h出院率明显大于传统组(P<0.05)；且阿片类药物平均使用剂量、羟考酮、曲马多和芬太尼联合使用的平均使用人次显著低于传统组，差异有统计学意义(P<0.05)。FTS组患者的住院费用明显低于传统组[(8796.69±1276.54)元比(9784.66±1517.09)元]，(P<0.05)。

结论

在小儿无并发症阑尾切除术中应用快速康复治疗可以缩短患儿的住院时间，减少术后镇痛药的使用，加快患者康复并减少患者的住院费用。

关键词: 阑尾炎, 康复, 治疗结果
Objective

To investigate the effect of Fast-track surgery (FTS) for uncomplicated appendicitis in children.

Methods

102 children with uncomplicated appendicitis and received fast-track surgery were selected as FTS group, and another 102 patients with uncomplicated appendicitis but received traditional surgery were selected as the control group from June 2014 to December 2017 in our hospital. The data were analyzed retrospectively. Statistical analysis was performed using SPSS version 24.0. The t-test was used to compare antibiotic dosage, analgesia usage, the number of analgesic usage between groups , the chi-square test was used to compare complication rates, rates of discharge within 24 h of admission between groups. Statistical significance was regarded as P<0.05.

Results

The length of post-operative stay, total length of stay in FTS group were significantly shorter than the traditional group, and the rate of discharge within 24 hours was significantly higher than the traditional group; the average dose of opioids, oxycodone, tramadol, and ondansetron was significantly lower than in the traditional group, and the difference was statistically significant (P<0.05); The direct-cost in the FTS group was significantly lower than that the traditional group [(8796.69±1276.54) Yuan vs. (9784.66±1517.09) Yuan] (P <0.05).

Conclusion

The application of fast-track surgery for uncomplicated appendicitis in children can shorten the total length of stay, reduce the dosage of analgesics, and accelerate the recovery of patients and save the costs.

Key words: Appendicitis, Rehabilitation, Treatment outcome
表1 204例小儿阑尾炎患者不同围术期处理方法两组患者住院时间及术后并发症比较[(±s)，h]
组别　 术后住院时间 总住院时间 24 h内出院率(n，%) 术后并发症(n，%)
FTS组 18.7±5.8 27.5±15.6 43(42.2) 4(3.9)
传统组 27.9±18.9 39.7±24.6 12(11.8) 6(5.9)
P值　 <0.05 <0.05 <0.05 >0.05
表2 204例小儿阑尾炎患者不同围术期处理方法两组患者术后用药、住院费用的比较(±s)
项目 FTS组(n＝102) 传统组(n＝102) P值
抗生素总计(n) 3.5±1.1 3.6±2.6 >0.05
阿片类药物剂量(mg/kg) 0.08±0.10 0.16±0.16 <0.05
羟考酮(n) 0.9±1.3 1.4±1.3 <0.05
曲马多(n) 0.5±0.8 1.0±1.1 <0.05
联合剂量(n) 0.3±0.5 1.1±1.1 <0.05
住院费用(万元) 0.88±1.28 0.98±1.52 <0.05
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