目的探讨快速康复外科(FTS)在超高龄胆总管结石患者中应用的安全性及有效性。方法收集开滦总医院肝胆外科2015年1—12月收治的36例80岁以上的择期手术患者,随机分为快速康复外科护理组(FTS)和常规护理组。常规护理组采用术后常规护理模式;FTS组采用加速康复的围术期处理方法,主要包括术前口服250ml葡萄糖液体,麻醉后留置鼻胃减压管和尿管,并在术后24h拔除;术中维持患者体温,控制补液量,留置硅胶腹腔引流管,与T管共同引出,术后24h未发现胆汁样引流物后拔除;术后早期活动、早期进食和采取有效的镇痛措施等。结果 FTS组患者的术后下床时间、术后排便时间和术后住院时间较常规护理组明显缩短(P<0.05),排气时间和住院费用差异有统计学意义(P<0.01);二组手术时间、术中出血量差异无统计学意义。结论在超高龄胆总管结石患者中应用FTS治疗是安全、有效的,可减少治疗费用,缩短住院时间,更好地促进患者早日康复。 Objective To investigate the safety and efficacy of rapid rehabilitation surgery (FTS) in the treatment of patients with choledocholithiasis. Methods Thirty-six patients undergoing elective surgery over the age of 80 were enrolled in the Department of Hepatobiliary Surgery, Kailuan General Hospital between January 2015 and January 2015. The patients were randomly divided into FTS group and routine care group. Conventional nursing group adopted routine nursing mode; FTS group used accelerated perioperative management methods, including preoperative oral 250ml glucose liquid, nasogastric decompression tube and catheter indwelling anesthesia, and after 24 hours of removal; Intraoperative maintenance of the patient’s temperature, control of fluid volume, indwelling peritoneal drainage tube of silicone, and T-tube co-leads, found no biliary drainage after 24 hours after removal; early postoperative activities, early eating and taking effective analgesic measures. Results The time of getting out of bed, postoperative defecation and postoperative hospital stay in FTS group were significantly shorter than those in routine nursing group (P <0.05), and the difference was statistically significant (P <0.01) There was no significant difference in the operation time and intraoperative blood loss between the two groups. Conclusion It is safe and effective to apply FTS in the treatment of patients with cholecystolithiasis. It can reduce the treatment cost, shorten the length of hospital stay and promote the early rehabilitation of the patients.