标题：临床路径结合快速康复外科理念在甲状腺良性肿瘤患者中的应用

      作者：肖勇 1，柯丹纯 2，叶小惠 2，黄素华 2，杨仲新 2    (深圳市宝安区松岗人民医院外科 1、手术室 2，广东 深圳 518105)

      卷次： 2017年28卷10期

      【摘要】 目的 探讨临床路径(CNP)结合快速康复外科理念(FTS)应用于甲状腺良性肿瘤(TBT)患者的临床效果。方法 选择我院2014年7月至2016年2月期间收治的214例TBT患者为研究对象，根据信封法分为观察组和对照组，每组107例，对照组患者实行围手术期常规管理，观察组则应用CNP结合FTS模式，比较两组患者围手术期临床指标以及胰岛素抵抗指数(HOMA-IR)的变化。结果 观察组患者术前等候时间、术后HOMA-IR、术后住院时间、术后住院费用分别为(2.3±0.6) d、(1.2±0.5)、(3.3±1.2) d、(7.6±1.2)×103元，均低于对照组的(3.1±0.9) d、(2.0±0.8)、(5.0±1.9) d、(8.3±1.3)×103元，差异均有统计学意义(P<0.05)；观察组患者手术并发症发生率为0.93%，明显低于对照组的5.61%，差异有统计学意义(P<0.05)。结论 临床路径结合快速康复外科理念应用于甲状腺良性肿瘤手术可以优化围术期临床指标，有效减轻手术应激反应，减少手术并发症，有利于术后的快速康复，并且可以减轻患者的经济负担。
      【关键词】 快速康复外科理念；临床路径；甲状腺良性肿瘤；应激反应
      【中图分类号】 R736.1 【文献标识码】 A 【文章编号】 1003—6350（2017）10—1581—03

Effect of clinical pathway combined with fast track surgery in patients with benign thyroid tumor.
XIAO Yong 1,KE Dan-chun 2, YE Xiao-hui 2, HUANG Su-hua 2, YANG Zhong-xin 2. Operation Room 1, Department of Surgery 2,Songgang People's Hospital of Baoan District of Shenzhen, Shenzhen 518105, Guangdong, CHINA
【Abstract】 Objective To investigate the clinical effect of clinical pathway (CNP) combined with fast track sur-gery (FTS) in patients with benign thyroid tumor (TBT). Methods From July 2014 to February 2016, 214 TBT patientsin our hospital were selected and randomly divided into the observation group and the control group according to the En-velope method, each group with 107 cases. The control group carried out routine perioperative management, and the ob-servation group applied CNP combined with FTS mode. Clinical index and HOMA-IR change were compared betweenthe two groups. Results The preoperative waiting time, postoperative HOMA-IR, postoperative hospitalization time,postoperative hospitalization costs in the observation group were (2.3±0.6) d, (1.2±0.5), (3.3±1.2) d, (7.6±1.2)×103 yuan,which were significantly lower than (3.1±0.9) d, (2.0±0.8), (5.0±1.9) d, (8.3±1.3)×103 yuan in the control group (P<0.05). The incidence of complications was 0.93% in the observation group, which was significantly lower than 5.61% in·论 著·doi:10.3969/j.issn.1003-6350.2017.10.011基金项目：广东省深圳市科技创新项目(编号：JCYJ20140414214831049)