摘要
目的观察加速康复外科(enhanced recovery after surgery,ERAS)在复杂泡型肝包虫手术中的应用.方法选自2013年1月至2016年10月年四川省人民医院肝胆外科收治泡型肝包虫病例117例,其中男60例,女57例,ASA分级Ⅰ~Ⅳ级,按照时间顺序分成3组:A组(n=35),传统管理组,所有患者按照既往流程行围术期管理;B组(n=44):过渡期管理组,按照ERAS流程进行操作;C组(n=38):标准流程组:所有患者在合作医院进行7~9 d适应性处理后入院,再完全按照ERAS流程进行操作.记录患者手术全程BP、HR、液体出入量、麻醉与手术时间、恶心、呕吐、感染等围术期并发症等.结果 3组心率、麻醉时间、手术时间,出血量、输血量及合并症发生率差异无统计学意义(P>0.05).A、B组术前饥饿口渴发生率、输液量、尿量、术后恶心、呕吐、感染等各类并发症发生率、平均住院床日大于C组(P<0.05).结论加速康复外科理念下肝包虫手术临床路径优化能明显降低患者围术期并发症,降低平均住院床日.
Objective To observe the application of enhanced recovery after surgery(ERAS)in complicated hepatic alveolar echinocoecosis surgery.Methods We selected 117 patients from 2013 to 2016 and divided them into 3 groups in chronological order:Group A(n=35),the traditional management group.All patients underwent perioperative management according to previous procedures.Group B(n=44),the transitional management group.The management in the transition period was improved as far as possible in accordance with the ERAS programme.Group C(n=38),the standard process group.All patients were treated in full accordance with standard process.The hemodynamics data,fluid volume and the perioperative complications were recorded in all groups.Results Compared with group C,there was no significant difference in the general condition and the incidence of complications before operation,the anesthesia time,the operation time,blood loss,blood transfusion and the heart rate in group A and B.The incidence of hunger and thirst before operation,infusion volume,urine output,the incidence of postoperative complications and the average length of hospitalization were all higher than those in group C.The differences were statistically significant.Conclusion The clinical path optimization of ERAS in liver hydatid surgery can significantly reduce the perioperative complications and reduce the average length of hospitalization.
作者
杨孟昌
邓小凡
李鹏
苏文杰
蒋蓉
温开兰
谢敏
YANG Meng-chang;DENG Xiao-fan;LI Peng;SU Wen-jie;JIANG Rong;WEN Kai-lan;XIE Min(Dept.of Anesthesiology,Sichuan Academy of Medical Science&Sichuan Provincial People’s Hospital,Chengdu Sichuan 610072,China)
出处
《昆明医科大学学报》
CAS
2018年第3期103-108,共6页
Journal of Kunming Medical University
基金
四川省卫生和划生育委员会资助课题(17PJ100)
关键词
快速康复外科
细粒棘球幼病
并发症
平均住院床日
Enhanced recovery after surgery
Echinococcus granulosus
Complication
The average length of hospitalization
