摘要
目的探讨加速康复外科(ERAS)在成人急性阑尾炎患者中的应用效果及价值。方法回顾性分析2017年7月—2018年6月在安徽理工大学第一附属医院普外科开腹手术治疗的70例成人急性阑尾炎患者的临床资料,其中男性35例,女性35例;年龄(41.4±14.6)岁,年龄范围为18~70岁。按围手术期管理方式不同分为研究组(n=35)和对照组(n=35),研究组围手术期采用ERAS为指导的系统有序地干预措施,对照组采用传统的围手术期管理方案。比较两组患者的术前白细胞、手术时间、术中出血量、住院天数、首次下床时间、肛门通气时间、术后24 h疼痛评分、术后并发症、术后72 h复查白细胞、总费用等的差异。正态分布的计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用χ2检验或Fisher确切概率法。结果研究组术前白细胞、手术时间、术中出血量、住院天数、术后72 h复查白细胞分别为(13.3±4.7)×10^9/L、(66.5±18.7)min、(11.7±6.6)mL、(5.8±1.6)d、(7.5±2.6)×10^9/L;对照组分别为(13.3±3.5)×10^9/L、(71.9±21.7)min、(12.5±7.1)mL、(7.3±2.7)d、(7.9±2.4)×10^9/L;两组相比差异均无统计学意义(P>0.05)。研究组首次下床时间、肛门通气时间、术后24 h疼痛评分、住院总费用、术后并发症分别为(8.3±1.4)h、(21.6±3.6)h、(2.3±0.5)分、(7058.0±1329.9)元、2例;而对照组分别为(11.1±2.8)h、(35.0±5.3)h、(3.4±0.8)分、(8621.3±2625.6)元、9例;两组相比差异均有统计学意义(P<0.05)。结论ERAS应用于急性阑尾炎围手术期管理是安全有效的,可以加快肛门通气、减轻术后疼痛、减少术后并发症、降低住院总费用,具有显著的社会经济效益。
Objective To explore the application effect and value of enhanced recovery after surgery(ERAS)in acute appendicitis.Methods The clinical data of 70 cases of adult acute appendicitis in the Department of General Surgery,First Affiliated Hospital of Anhui University of Science and Technology from July 2017 to June 2018 were analyzed retrospectively,including 35 males and 35 females,aged(41.4±14.6)years and ranging from 18 to 70 years.According to the different perioperative management methods,the study group was divided into study group(n=35)and control group(n=35).The study group adopted systematic and orderly intervention measures guided by ERAS during the perioperative period,and the control group adopted the traditional perioperative management scheme.The differences in the preoperative white blood cells,operation time,intraoperative bleeding,the first time of get out the bed,the time of anus ventilation,the 24 hour postoperative pain score,the hospital days,postoperative complications,leukocyte examination 72 days after operation and total cost were compared between the two groups.Measurement data were expressed by mean±standard deviation(Mean±SD).T test was used for comparison between groups.Counting data were expressed by percentages,and chi-square test and Fisher test were used in comparison between groups.Results In the study group,the leukocytes before operation,operation time,intraoperative blood loss,hospital stay and leukocyte examination 72 days after operation were respectively(13.3±4.7)×10^9/L,(66.5±18.7)min,(11.7±6.6)mL,(5.8±1.6)d,(7.5±2.6)×10^9/L;while the control group were respectively(13.3±3.5)×10^9/L,(71.9±21.7)min,(12.5±7.1)mL,(7.3±2.7)d,(7.9±2.4)×10^9/L.There was no significant difference between the two groups(P>0.05).In the study group,the first time to get out of bed,the time of anal ventilation,the 24 hour postoperative pain score,the total cost of hospitalization and postoperative complications were(8.3±1.4)h,(21.6±3.6)h,(2.3±0.5)scores,(7058.0±1329.9)yuan,2 csaes;while the control group were respectively(11.1±2.8)h,(35.0±5.3)h,(3.4±0.8)scores,(8621.3±2625.6)yuan,9 cases;The difference between the two groups was statistically significant(P<0.05).Conclusions The application of ERAS in the perioperative management of acute appendicitis is safe and effective.It can accelerate the anal ventilation,reduce postoperative pain,reduce postoperative complications,reduce the total hospitalization costs,and have significant social and economic benefits.
作者
卢曼曼
冯其柱
Lu Manman;Feng Qizhu(Department of Clinical Laboratory,First Affiliated Hospital of Anhui University of Science and Technology,Huainan 232007,China;Department of General Surgery,First Affiliated Hospital of Anhui University of Science and Technology,Huainan 232007,China)
出处
《国际外科学杂志》
2020年第6期378-382,共5页
International Journal of Surgery
基金
安徽理工大学自然科研课题(QN2018131)。
关键词
阑尾炎
阑尾切除术
围手术期医护
加速康复外科
Appendicitis
Appendectomy
Perioperative care
Enhanced recovery after surgery
