摘要
目的:探讨加速康复外科在老年患者腹腔镜腹股沟疝修补术中的安全性、可行性及临床价值。方法:回顾分析2015年1月至2017年6月108例老年腹股沟疝患者行腹腔镜疝修补术的临床资料,患者分为两组,A组围术期采用加速康复外科,B组采用常规治疗,分析两组术后疼痛评分、术后尿潴留发生率、住院时间、住院费用、血清肿及术后慢性疼痛。结果:A组术后第1天疼痛数字评分[(2.38±0.86) vs.(3.47±1.09),t=5.797,P=0.000]、术后尿潴留发生率[1.8%(1/55) vs. 15.1%(8/53),χ~2=4.611,P=0.032]、住院时间[(3.48±0.69)d vs.(5.89±0.74)d,t=17.395,P=0.000]、总住院费用[(8 935±290)元vs.(10 021±706)元,t=10.523,P=0.000]优于B组;两组术后血清肿、术后慢性疼痛发生率差异无统计学意义(P>0.05)。结论:遵循加速康复外科理念为老年腹股沟疝患者行腹腔镜疝修补术安全、可行,可降低术后尿潴留发生率,缩短住院时间,降低住院费用,促进患者快速康复。
Objective:To investigate the safety,feasibility and clinical value of enhanced recovery after surgery(ERAS)in laparoscopic inguinal hernia repair in aged patients.Methods:The clinical data of 108 aged patients who underwent laparoscopic inguinal hernia repair from Jan.2015 to Jun.2017 were analyzed retrospectively.Patients were divided into 2 groups:group A received ERAS in perioperative period,and group B received routine treatment.The postoperative pain score,postoperative urinary retention incidence,hospital stay,hospital expenses,seromas and postoperative chronic pain of the two groups were analyzed.Results:The group A was better than the group B in pain score on the first day after operation[(2.38±0.86)vs.(3.47±1.09),t=5.797,P=0.000],the incidence of urinary retention[1.8%(1/55)vs.15.1%(8/53),χ~2=4.611,P=0.032],the hospitalization time[(3.48±0.69)d vs.(5.89±0.74)d,t=17.395,P=0.000],and the total hospitalization cost[(8 935±290)yuan vs.(10 021±706)yuan,t=10.523,P=0.000].However,there was no significant difference in the incidence of postoperative seroma or chronic pain between the two groups(P>0.05).Conclusions:Laparoscopic inguinal hernia repair under ERAS is safe and feasible in aged patients.It can reduce the incidence of urinary retention,the hospitalization time and the cost of hospitalization,can promote the rapid rehabilitation of patients.
作者
刘召洪
王家兴
李捷
LIU Zhao-hong;WANG Jia-xing;LI Jie(Department of General Hospital,Panzhihua Iron&Steel Group General Hospital,Panzhihua 617000,China)
出处
《腹腔镜外科杂志》
2019年第5期367-370,共4页
Journal of Laparoscopic Surgery
关键词
疝
腹股沟
疝修补术
腹腔镜检查
老年人
加速康复外科
Hernia,inguinal
Herniorrhaphy
Laparoscopy
Aged
Enhanced recovery after surgery
