王洪健 侯远发 唐波

[摘要] 目的 分析对接受肝内外胆管结石手术治疗的患者的围术期行快速康复外科理念干预的临床疗效情况。方法 方便选取80例接受肝内外胆管结石手术治疗的患者作为临床研究对象，入院时间为间2017年1月—2019年4月，以围术期干预方式的不同分两组，实行常规干预的患者设为对照组（40例），实行快速康复外科理念干预的患者设为观察组（40例），比对治疗效果改善情况。 结果 术后，观察组患者的术后排气时间（20.87±5.55）h、下床活动时间（20.98±1.33）d以及术后住院时间（7.08±1.98）d显著低于对照组，两组比较差异有统计学意义（t=12.362、9.346、8.195，P<0.05）;对照组患者的不良反应发生率20.00%显著高于观察组5.00%，差异有统计学意义（χ2=5.362，P<0.05）。 结论 在快速康复理念指导下进行肝内外胆管结石手术，可有效缩短患者康复时间，降低术后不良反应发生率，有较高的临床应用价值。

[关键词] 肝内外胆管结石手术;快速康复外科理念;临床疗效

[中图分类号] R657.4          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0004-03

Application of Rapid Rehabilitation Surgery in Intrahepatic and Extrahepatic Bile Duct Stones

WANG Hong-jian1， HOU Yuan-fa1， TANG Bo2

1.Department of Abdominal Surgery， Yunfu People's Hospital， Yunfu， Guangdong Province， 527300 China; 2. Department of Anesthesiology， Yunfu People's Hospital， Yunfu， Guangdong Province， 527300 China

[Abstract] Objective To analyze the clinical efficacy of perioperative rapid rehabilitation surgery in patients undergoing intrahepatic and extrahepatic bile duct stones. Methods Eighty patients with intrahepatic and extrahepatic bile duct stones were enrolled as clinical subjects. The admission time was from January 2017 to April 2019. Patients were convenient divided into two groups according to the perioperative intervention. The control group with routine intervention （40 cases） and the observation group with rapid rehabilitation surgery（40 cases）， and the improvement effect was compared. Results After operation， the postoperative exhaust time （20.87±5.55）h， the time of getting out of bed（20.98±1.33）d and the postoperative hospital stay （7.08±1.98）d were significantly lower in the observation group than in the control group. The difference was statistically significant（t=12.362， 9.346， 8.195， P<0.05）. The incidence of adverse reactions in the control group was 20.00% significantly higher than that in the observation group （5.00%）， and the difference was statistically significant（χ2=5.362， P<0.05）. Conclusion Under the guidance of rapid rehabilitation concept， intrahepatic and extrahepatic bile duct stones can effectively shorten the recovery time of patients and reduce the incidence of postoperative adverse reactions， which has high clinical application value.

[Key words] Intrahepatic and extrahepatic bile duct stones surgery; Rapid rehabilitation surgical concept; Clinical efficacy

近年來，随着医学技术的发展，社会文明的进步，传统单纯的生物模式已无法满足患者的需求，接受手术治疗的患者对促进术后康复、降低住院费用以及缩短术后住院时间要求更高了[1-2]。但目前该理念在肝胆外科手术中应用率较低，现为了探究将快速康复理念应用于接受肝内外胆管结石手术治疗的患者中的临床效果，特方便选取80例该疾病患者（入院时间为2017年1月—2019年4月）作为临床研究对象，探究其临床应用效果，现报道如下。

1  资料与方法

1.1  一般资料

方便选取80例接受肝内外胆管结石手术治疗的患者作为临床研究对象，以围术期干预方式的不同分两组。观察组患者中男性患者21例，女性患者19。年龄范围为45～79岁，平均年龄（55.87±5.01）岁;平均体质量范围（62.87±22.87）kg;ASA分级：Ⅲ级者5例，Ⅱ级者30例，Ⅰ级者5例;结石位置：肝内外胆管结石者13例，胆总管结石者11例;肝内胆管结石者16例。……