摘要
目的描述加速康复外科(ERAS)理念下妇科生殖手术患者的康复曲线,探究患者术后生活质量及术后恢复时间的影响因素。方法收集2022年6-9月在北京协和医院妇科行择期生殖手术的患者151例,统计患者围手术期ERAS措施完成情况,采用欧洲五维健康量表(EQ-5D)进行视觉刻度值(VAS)评分。针对年龄、体质量指数(BMI)、术前血红蛋白(HGB)、手术时长、住院天数、ERAS具体措施(包括术前评估与宣教、纠正术前贫血及营养不良、取消术前常规肠道准备等26条)采用SPSS 25.0统计软件进行多因素分析。结果所有患者均成功实施手术,其中19例失访,失访率12.58%,最终132例纳入统计学分析,其中腹腔镜手术112例、开腹手术20例。术后达到健康状态的平均天数为(18.54±13.04)d。术前VAS评分为(82.97±13.11)分,手术当天(65.04±17.86)分,术后第1天(71.73±14.04)分,术后第2天(77.36±11.22)分,达到健康状态时为(91.36±7.77)分。根据VAS评分可画出一条围手术期康复曲线。多因素分析提示,术前VAS评分、避免术前使用镇静药物、术后恶心呕吐(POVN)的预防是术后VAS评分的主要影响因素(P<0.05),而术前HGB水平及POVN的预防是术后恢复时间的主要影响因素(P<0.05)。结论加速康复外科可以加速妇科生殖手术患者围手术期的恢复,提高术后生活质量。
Objective:To describe the rehabilitation curve of patients undergoing gynecological and reproductive surgery under the concept of Enhanced Recovery After Surgery(ERAS),and to explore the influencing factors of postoperative quality of life and postoperative recovery time.Methods:A total of 151 patients who underwent gynecological elective reproductive surgery in Peking Union Medical College Hospital from June 2022 to September 2022 were collected.The completion of perioperative ERAS was counted and visual analogue score(VAS)was scored by European five-dimensional Health scale(EQ-5D).According to age,body mass index(BMI),preoperative hemoglobin(HGB),length of operation,length of stay,specific measures of ERAS(including preoperative evaluation and education,correction of preoperative anemia and malnutrition,cancellation of routine intestinal preparation,and other 26 items).SPSS25.0 statistical software was used for multivariate analysis.Results:All patients were operated successfully,19 patients lost follow-up,with a loss rate of 12.58%.Finally,132 patients were included in statistical analysis,including laparoscopic surgery(n=112)and laparotomy(n=20).The average postoperative health time was(18.54±13.04)days.The VAS score was(82.97±13.11)before surgery,(65.04±17.86)on the day of surgery,(71.73±14.04)on the first day after surgery,(77.36±11.22)on the second day after surgery,and(91.36±7.77)when reaching a healthy state.A perioperative recovery curve can be drawn according to VAS score.Multivariate analysis showed that preoperative VAS score,prevention of preoperative use of sedative drugs and postoperative nausea and vomiting(POVN)were the main influencing factors of postoperative VAS score,while preoperative HGB and POVN prevention were the main influencing factors of postoperative recovery time(P<0.05).Conclusions:ERAS measures can optimize the perioperative recovery of patients undergoing gynecological reproductive surgery and improve the quality of life after operation.
作者
邓鑫
贾雪敏
钟晓盈
樊庆泊
史宏晖
于昕
曹杨
王姝
刘海元
DENG Xin;JIA Xue-min;ZHONG Xiao-ying;FAN Qing-bo;SHI Hong-hui;YU Xin;CAO Yang;WANG Shu;LIU Hai-yuan(Department of Obstetrics&Gynecology,National Clinical Research Center for Obstetrics&Gynecologic Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing100730)
出处
《生殖医学杂志》
CAS
2023年第3期386-391,共6页
Journal of Reproductive Medicine
关键词
妇科
生殖
围手术期
欧洲五维健康量表
加速康复外科
Gynecology
Reproduction
Perioperative period
EQ-5D
Enhanced recovery after surgery
作者简介
邓鑫,女,湖南衡阳人,硕士研究生,妇产科学专业;通讯作者:刘海元。
