Abstract: Objective To explore the feasibility of the improved on traditional rapid enhanced recovery after surgery（ERAS），for providing more perfect model of clinical treatment in laparoscopic cholecystectomy（LC）. Mothed The patients required cholecystectomy from Feb 2017 to jun 2016 were divided into either improved?ERAS group and traditional?ERAS group，with 71 cases in each group. The preoperative tensity，operation time，intraoperative bleeding，micturition and flatus time，time to get out off bed，time to intake general diet，level of incision pain，days of in?hospital，and hospitalization coast were compared. Results Compared with traditional?ERAS group ，postoperative complication rate of improved?ERAS group was low. The improved ERAS group had shorter micturition time（7.18 ± 1.30 vs. 6.63 ± 1.62h）， shorter flatus time（17.48±0.61 vs. 15.45±0.75 h），shorter time to get out off bed（12.75±1.05 vs. 12.27±1.71 h），shorter time to general diet（30.41±5.84 vs. 26.80±4.91 h），lower coast（12794.1±2737.3 vs 11092.8±2368.9 yuan），shorter days of in?hospital（7.3±3.2 vs. 5.9±2.5days），and patients′ subjective feeling were superior to traditional?ERAS group（P<0.001）. Conclusion Laparoscopic cholecystectomy is applied to traditional ERAS after improvement and optimization could shorten the length of in?hospital and reduce the pain of patients during perioperation.It will provide new methods and ideas for ERAS.

Key words: laparoscopic, improved rapid enhanced recovery after surgery, cholecystectomy

摘要： 目的 探讨对传统快速康复外科进行改良的可行性，为腹腔镜胆囊切除手术提供更优化、更完善的临床治疗模式。方法 选择2017 年2 月~2018 年6 月间需行腹腔镜胆囊切除手术的病人并按入院顺序分成为改良快速康复外科组（改良组）和传统快速康复外科组（传统组），每组各 71 例，全面对比分析两组在术前紧张度、手术时间、术中出血量、排尿排气时间、自主下床时间、切口疼痛程度、恢复普食时间、住院天数及住院费用的差异。结果 与传统组相比，改良组病人术后并发症发生率较传统组低。改良组术后排尿早 7.18±1.30 h vs. 6.63±1.62 h，排气早 17.48±0.61 vs. 15.45±0.75 h，自主下床早 12.75±1.05 vs. 12.27±1.71 h，恢复普食早（30.41±5.84 vs.26.80±4.91）h，费用减低（12794.1±2737.3 vs. 11092.8±2368.9）元，住院时间缩短（7.3±3.2 vs. 5.9±2.5）天，病人的主观感受优于传统组（P<0.001）。结论 传统快速康复外科经改良优化后应用腹腔镜胆囊切除手术，缩短住院天数，减少病人围术期痛苦，为快速康复提供了新的方法和思路。

关键词: 胆囊切除, 改良快速康复外科, 腹腔镜