partment of General S urgery, West China Hos pital, S ichuan Universit y, Cheng du , China

Transcription

1 ( 2007) R R A Fast2Track Programmes of Multi2Disciplinary Team in Colorectal Surgery L IU Zhan, W A N G X iao2dong, L I L i. De2 partment of General S urgery, West China Hos pital, S ichuan Universit y, Cheng du , China Abstract Objective To explore the content and scientific evidence of every element of the fast2track pro2 grammes in colorectal surgery. Methods The literatures about the applied status and opinion of the modality applied in the surgical treatment of the colorectal cancer and fundament investigation in recent years were collected and re2 viewed. Results The feasibility of the every fast2track s element was based on the clinical and fundamental investi2 gaton. Conclusion The advantage of the fast2track programmes in colorectal surgery is confirmed. Key wordscolorectal surgery Fast2track programme Content Evidence (fast2track,ft) [1 ],, F T 1 [2,3 ],,,, / [4 ] :,, [5 ] 2 13 d FT, Brown2 son [6 ],, (), ; Baker 3 ( ) ; : ( ),,,, [7 ],, ; Santos [8 ] Schein [9 ],, ; Graney [10 ] h,, [11 ] ; [9 ],,, [12 ],,, [5,11,12 ] Slim [12 ] 2 h, 3, [13 ] FT, 6 h, 2 h ml [5 ]

2 Chin J Bases Clin General Surg, Vol. 14, No. 4, J uly 2007 [14 ], [15 ],, [16 ], [17 ] 4 Caumo [18 ],, ; Hausel [14 ], Meta [19 ], [5 ] 5,,, [20 ] 212 h,, [21 ] FT,,FT Lausen [21 ] [22,23 ] ; : 12 h, 28 h,,, ;, [5 ], 50 %, [5 ] 6 3 : ; ;, [5 ] 7 ( mid2thoraic epidural anaesthesia) T6T8 ( T9T10 ),(0. 25 % 4 ml/ h 0. 2 mg/ h), 4872 h [2426 ] Wilmore [27 ], Kehlet [28 ], 22, ( ),,,,, FT [24 ], ( ) [28 ],,Meta [29 ],,, [30 ] 8 F T [27 ], F T, [24,25,27,31,32 ] [24 ],, [33,34 ], [24 ] 9 F T ( ) [35 ],(combined effect) [24 ], [27 ] Schuster [35 ],, Mattei [24 ],, Wind [32 ], FT,, Basse [36 ], FT,,, F T [24 ] 10 Cheatham [37 ] Meta, [5 ] 26 Meta,,, [37 ], ( ) [24 ] ;

3 471 ;, [5 ] 11,,, 2 h,2 4,3 [38 ], (, ) [5 ], ( ) [39 ], [40 ] :, [27,32 ] 12,,,, [41 ] [42,43 ] ;,, [44 ] :, Basse [45 ], 1 d 2 d ; [46 ] ; 2 h, 800 ml, [5 ] 13 Urbach [47 ] Meta 14 [44 ] 24 h FT [5 ] 15 FT, 4 h (oral nutritional supplements,ons) (400 ml ), [5 ] [48 ],1224 h, 2448 h,35 d,, [24 ] FT, 1 d 4 d, [45,49,50 ],,, [51 ] ; [52,53 ],, Fearon [5 ] 16 FT ; Fearon [5 ], ; 2 h, 6 h, 17 F T : ;, ; ;,, F T Fearon [5 ],,,, 18 FT,23 d,10 %20 % 1 h [45,54 ] 24 h, (: ),,2448 h 710 d,: 30 d,, Fearon [5 ],F T, ; 1 % 3 %( ),,FT 19 F T,, FT [5 ] FT

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