加速康复外科和传统外科在肋骨骨折围手术期的应用比较

目的：比较加速康复外科（fast track surgery，FTS）理念和传统外科方法在肋骨骨折围手术期的应用。方法选择肋骨骨折患者84例，围手术期应用加速康复理念42例（FTS组），应用传统外科手术42例（传统组），将两组手术后疼痛VAS评分、血清白蛋白检测结果、肠鸣音恢复时间、首次通气时间、术后并发症（消化道症状、消化性溃疡、胸腔出血、肺不张、肺部感染、胸腔积液、心脏并发症、泌尿系统并发症、切口感染、深静脉血栓）发生率、住院时间及住院总费用、患者满意度等进行比较。结果 FTS组术后疼痛VAS评分较传统组低，血清白蛋白较传统组高，肠鸣音恢复时间及首次通气时间提前，术后并发症发生率较低，住院时间缩短，住院费用降低，患者满意度提高，两组比较差异有统计学意义（P＜0．05）。结论 FTS应用于肋骨骨折围手术期患者的术后疼痛VAS评分低，营养状况较好，肠道恢复较早，术后并发症发生率较低，住院时间缩短，治疗费用降低，患者满意度提高，值得进一步推广。

A comparison of the perioperative application of fast track surgery and traditional surgery for fractured ribs

Objective To compare the perioperative application of fast track surgery（FTS）andtraditional surgery for fractured fibs.Methods Eighty four perioperative patients with fractured fibs wereenrolled,including 42 cases treated by FTS philosophy（FTS Group）and 42 cases treated by traditional sur gery（Tradition Group）.The results of postoperative VAS score,serum albumin,recovery time of gurglingsound,exhaust time of intestinal tract,postoperative complications,hospital stay,total hospital cost and pa tient satisfaction were investigated and compared between the two groups.Results Patients in FTS grouphad lower VAS scores,higher level serum albumin,earlier time of gurgling sound recovery and intestinalexhaust,lower rates of postoperative complication,shorter time of hospital stay,lower hospital costs andhigher levels of satisfaction（P 〈0.05）.Conclusion For perioperative patients with fractured fibs,FTShas advantages in low VAS score,good nutrition condition,short intestinal tract convalescence,low postop erative complication rate,short hospital stay,low host costs and high level of satisfaction,which is worthy ofbeing spread.