全球精选文摘 - 快速通道方案在结直肠外科中的应用：一项前瞻性随机临床试验

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快速通道方案在结直肠外科中的应用：一项前瞻性随机临床试验

Implementing Fast-Track Protocol for Colorectal Surgery: A Prospective Randomized Clinical Trial

Ionescu D, Iancu C, Ion D 2010/5/10 15:57:20

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World J Surg, 2009,

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Background:
Fast-track protocols are followed by an enhanced recovery, early return to bowel function and to complete nutrition, and a reduced hospital stay. Our study was designed to implement fast-track protocol in our university hospital.

Methods:
The 96 consecutive patients with colorectal neoplasm included in the study were randomized in two equal groups: group 1 (FT) included patients undergoing colorectal surgery in a fast-track protocol, and group 2 (C) included patients undergoing colorectal surgery with a conventional care protocol. As with other fast-track protocols, our protocol included carbohydrate fluids load before operation, early mobilization and oral feeding, regular prokinetics, and multimodal postoperative analgesia. Time to restoration of bowel function, to complete mobilization and feeding, length of hospital stay, and incidence of complications and readmissions were monitored.

Results:
Time to mobilization, restoring of bowel function, and complete oral feeding were significantly shorter with fast-track protocol (p=0.001, p=0.042, and p=0.01, respectively). Hospital stay also was shorter in the fast-track group (p=0.001). The incidence of complications did not significantly differ with the study groups.

Conclusions:
In our study, fast-track protocol resulted in a shorter time to mobilization, complete feeding, and discharge from hospital. Fast-track protocol did not increase the incidence of complications. However, we consider that our data require further confirmation with powered multicenter national studies.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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