分析精准外科结合快速康复(FTS)理念在肝癌术围术期处理中的应用。

回顾性分析2018年6月至2020年6月收治的83例接受FTS理念的肝癌患者病例资料，采用常规开腹术。根据围手术期处理方式不同分为两组：FTS组43例和传统组40例，FTS组给予FTS指导下的围术期处理方式，对照组仅给予常规围术期处理方式。采用SPSS18.0统计分析软件，符合正态分布的术后相关指标、肝功指标、术后疼痛情况以(±s)表示，采用独立样本t检验；并发症发生率采用χ²检验。P<0.05为差异有统计学意义。

与传统组相比，FTS组术后排气、排便、拔胃管和住院时间较短，差异均有统计学意义(P<0.05)。FTS组术后并发症总发生率较传统组低(9.3% vs. 30.0%)，差异有统计学意义(P<0.05)。两组术后总胆红素、血清白蛋白、丙氨酸氨基转移酶水平差异无统计学意义(P>0.05)。FTS组术后6 h、12 h、1 d、2 d视觉模拟评分法(VAS)评分均比传统组低(P<0.05)。

精准外科结合FTS在肝癌术围术期处理中的应用可减少患者住院时间，缓解其疼痛情况，避免相关并发症的发生。

To investigate the clinical outcome ofprecision surgery combined with fast recovery concept of perioperative management of hepatectomy for primary liver cancer.

Clinical data of 83 patients with HCC who had received precise surgical resection in Anhui medical university between June 2018 to June 2020 were analyzed retrospectively. According to different perioperative treatment methods, the patients were divided into two groups: fast recovery (FTS) group(n=43) and traditional group(n=40). In the FTS group, the patients received the perioperative treatment under the guidance of rapid recovery concept. In the traditional group, the patients received the conventional perioperative treatment. Statistical analysis were performed by using SPSS 18.0 software. Postoperative conditions, liver function indicators and postoperative pain , which were conformed tobe normal distribution, were expressed as, (±s) and were examined by using independent t test . The complication rate was analyzed by using χ² test. A P value of < 0.05 was considered as statistically significant difference.

Compared with the traditional group, the FTS group had shorter postoperative exhausting time, defecation time, gastric tube extubation time and hospital stay (P<0.05). The total incidence of postoperative complications in the FTS group was 9.31%, which was lower than 30.0% in the traditional group (P<0.05). There were no significant difference in terms of total bilirubin, serum albumin and alanine aminotransferase between the two groups (P>0.05). VAS scores 6 h, 12 h, 1 d and 2 d after surgery in the FTS group were significant lower than those in the traditional group respectively (P<0.05).

The application of precision surgery combined with the concept of fast recovery in perioperative management of hepatocellular carcinoma could reduce the time of hospitalization, could relieve pain and avoid related complications.