摘要
目的探讨加速康复外科(ERAS)理念应用于腹腔镜肾部分切除术患者围术期管理的安全性和有效性。方法将105例腹腔镜肾部分切除术患者分为ERAS组(n=55)和对照组(n=50)。对照组采用常规传统围术期方案,ERAS组采用ERAS方案。比较2组患者术后恢复情况、应激指标、并发症发生情况以及术后1个月随访的非预期再住院情况。结果ERAS组术后首次饮水时间、首次通气时间、首次下床活动时间、引流管留置时间、尿管留置时间及术后住院时间均短于对照组,差异有统计学意义(P<0.05)。ERAS组术后24 h疼痛评分低于对照组,差异有统计学意义(P<0.05)。ERAS组术后第3天血清白细胞计数(WBC)以及术后第3、5天C反应蛋白(CRP)水平低于对照组,差异有统计学意义(P<0.05)。2组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论ERAS用于腹腔镜肾部分切除术患者围术期管理安全性较好,同时可减轻术后应激反应,促进早期康复。
Objective To explore the safety and effectiveness of the concept of enhanced recovery after surgery(ERAS)applied to the perioperative management of patients undergoing laparoscopic partial nephrectomy.Methods A total of 105 patients with laparoscopic partial nephrectomy were divided into ERAS group(n=55)and control group(n=50).The conventional perioperative protocol was used in the control group,and the ERAS protocol was used in the ERAS group.The postoperative recovery,stress indexes and incidence of complications were compared between the two groups,and the unexpected readmission rate at one month after surgery was compared during follow-up.Results After operation,the first time of drinking water,first time of ventilation,first time of getting out of bed,indwelling time of drainage tube,indwelling time of urinary tube and postoperative hospitalization time in the ERAS group were significantly shorter than those in control group(P<0.05).The 24 hours postoperative pain score of the ERAS group was significantly lower than that of the control group(P<0.05).Serum white blood cell count(WBC)at the 3 rd day after surgery and C-reactive protein(CRP)levels at the 3 rd and 5 th day after surgery of the ERAS group were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion ERAS is safe for perioperative management of patients undergoing laparoscopic partial nephrectomy.At the same time,it can relieve postoperative stress reaction and promote early postoperative recovery.
作者
石群
邓泽勋
彭鑫鑫
顾晓
吴银霞
郭宝玉
郭哲
俞俊杰
SHI Qun;DENG Zexun;PENG Xinxin;GU Xiao;WU Yinxia;GUO Baoyu;GUO Zhe;YU Junjie(Department of Urological Surgery,Xianning Central Hospital of Hubei Province,First Affiliated Hospital of Hubei University of Science and Technology,Xianning,Hubei,437100;Department of Urological Surgery,Clinical Medical College of Yangzhou University,Yangzhou,Jiangsu,225001;Department of Oncology,Clinical Medical College of Yangzhou University,Yangzhou,Jiangsu,225001)
出处
《实用临床医药杂志》
CAS
2021年第6期34-37,41,共5页
Journal of Clinical Medicine in Practice
基金
江苏省“六大人才高峰”高层次人才项目(WSW 255)
江苏省青年医学人才项目(QNRC 2016335)
江苏省扬州市重点医学人才项目(ZDRC20185、ZDRC201861)
中国博士后项目(2017M611755)
关键词
加速康复外科
肾癌
腹腔镜肾部分切除术
围术期
enhanced recovery after surgery
renal carcinoma
laparoscopic partial nephrectomy
perioperative period
作者简介
通信作者:俞俊杰,E-mail:urologistyjj@163.com
