The Clinical Application Research Of The Fast Track Surgery In The Operation Of Acute Abdominal Diease

Background and objectiveAcute abdominal disease refers to the acute need emergency treatment of acute abdominal pain as the main performance of the floorboard of the surgical emergency,a series of surgical acute abdominal diease include acute appendicitis, perforation of the digestive tract, acute intestinal obstruction, acute biliary tract infection, cholelithiasis, acute pancreatitis, abdominal trauma. Fast tract surgery is to point to in perioperative by integrated application of multidisciplinary method,reasonably and effectively improved a series of normal diagnosis and treatment measures to minimize the surgical stress, to reduce the operation risk and complications, eventually to speed up the patients with postoperative recovery, improve the quality of recovery, shorter hospital stay, the essential purpose of the core connotation is as far as possible to reduce or even block is given priority to with operation of all kinds of invasive diagnosis and operation caused by the body’s stress response. As one of the latest treatment concept and principles of the surgical field, fast tract surgery concept once applied to clinical practice shows that it gains a superior treatment effect than traditional idea,and spread quickly in the surgery of the various disciplines, from the original main application in colorectal surgery gradually extended to almost all of the surgical field. But so far to fast tract surgery is still the main applied to elective surgery, accelerated rehabilitation surgery in acute abdominal disease about the application value of the relevant report is still rare, this paper discusses to accelerate rehabilitation surgery is applied to the feasibility of the acute abdominal disease. MethodsFrom 2013.3 to 2014.3, patients with acute abdominal disease and admitted in the Emergency Care Center of The First Affiliate Hospital of Zhengzhou University were collected. Patients were classified according to disease category, every classification of patients were divided into fast track surgery( FTS) group and conservative treatment surgery(CTS)group randomly.Biochemical and clinical markers of the two groups were collected and compared. Statistical analysisStatistical treatment is completed wih SPSS 13.0 package. Measurement data is expressed by mean( x)±standard deviation(s), according to measurement data, group comparison between groups using t- test, ANOVA is used in comparision within repeated measurement data set, the group ratio comparision is analyzed by chi-square, Comparison between groups of level data is analyzed by rank test. P < 0.05 for the difference was statistically significant. ResultsThere were no significance difference of preoperative,C-reactive protein(CRP),prealbumin(PA),age and gender composition between groups(P>0.01).While compared with CTS group,FTS group have a lower CRP,complication rate and hospital cost,a higher PA,a shorter time of bowel function recovery,first MOF multiple organ failure多器官功能衰竭TNF tumor necrosis factor肿瘤坏死因子IL interleukin白细胞介素FTS fast track surgery加速康复外科CTS conservative treatment surgery传统手术PCEA patient controlled epidural analgesia自控硬膜外镇痛泵PCIA patient controlled venous analgesia自控静脉镇痛泵WBC white blood cell白细胞CRP C-reactive protein C反应蛋白PA prealbumin前白蛋白ARDS acute respiratory distress syndrome急性呼吸窘迫综合征DCS damage control surgery损伤控制外科TIC trauma induced coagulopathy创伤性凝血病SV stroke volume每搏量CO cardiac output心排出量SVV stroke volume variation每搏变异率PVI pleth variability index脉搏灌注指数变异ASA American Society of Anesthesiologists美国麻醉医师协会postoperative ingress and hospital stay,and a lighter WHO pain rating scale(P All<0.01).ConclusionsFTS applies to the perioperative of the patients who need emergency surgery with an acute abdomen includes acute appendicitis, acute cholecystitis, acute intestinal obstruction, upper gastrointestinal perforation, acute pancreatitis.FTS is innovative and practical, then it can be widely used in emergency surgery.