The Concept Of Fast Track Surgery In The Primary Hospital Laparoscopic Cholecvstectomy

ObjectiveExplore the concept of fast track surgery in basic level hospital laparoscopic cholecystectomy surgery in implementation, and the difficulties encountered in the process of exploring factor analysis. MethodThe collection of Xianyang Central Hospital in November 2013 to April 2014 a total of 106 patients undergoing laparoscopic cholecystectomy patients, including 95 cases of cholecystolithiasis, 11 cases of gallbladder polyps. Male 36 cases, female 70 cases, age 22 ~ 77 years old, the average age is 48.8 years old, course in 3 month ~ 5 years. According to the randomized into observation group, control group. All control by using traditional LC treatment groups in peri operation period, routine preoperative fasting, do not control the body temperature during operation, transfusion volume does not limit the intraoperative, postoperative conventional rehydration, routine postoperative intravenous analgesia pump, postoperative ambulation in patients with postoperative stay intention, anal exhaust after eating. The observation group of 53 cases, the observation group patients in peri operation period of concept of using FTS treatment, preoperative oral carbohydrate, heat preservation in surgery, strictly limit the amount of liquid in the operation, control fluid volume after operation, postoperative analgesia using oral analgesic and wound ropivacaine anesthesia treatment, postoperative early patients into the diet of patients with early get out of bed, postoperative, no need of anal exhaust. Observe two groups of patients with postoperative anal exhaust time for the first time, eating time after operation, postoperative hospital stay, total cost of hospitalization, postoperative given strict follow-up of 1 weeks, postoperative complications, satisfaction of hospitalized patients. Statistical analysis of the data with SPSS 16 software, numerical variables to x±s, two between the mean were compared with t test, categorical variables are expressed as a percentage, two of the sample rate and constituent ratio using X 2. ResultsDuring peri operation period of application of rapid rehabilitation treatment of laparoscopic cholecystectomy, than traditional concept of peri operation period of application of laparoscopic cholecystectomy after eating time average as early as 7.9h, for the first time, anal exhaust time ahead of the average 7.2h, the average postoperative hospitalization is shortened 3 days, total hospital costs an average reduction of 755.3 yuan. Two groups of patients with postoperative patient satisfaction in the hospital survey results are high, the observation group satisfaction was 94.3%, the control group of satisfaction is 92.5%, no significant difference between two groups. The patients in the observation group and 4 cases of complications, the control group were 5 cases occurred complications, two groups of patients with postoperative complications had no statistical difference. ConclusionPeri operation period of rapid rehabilitation surgery by laparoscopic cholecystectomy under the guidance of the concept of resection than traditional laparoscopic cholecystec tomy after eating early, early postoperative anal exhaust time, reduces the transfusion, hospitalization duration and cost, and no increase in postoperative complications, achieved good clinical results. The concept of rapid rehabilitation surgery in laparoscopic cholecystectomy in primary hospital resection can be widely applied in operation.