加速康复外科理念在胰十二指肠切除术围手术期中的应用

The concept of Enhanced Recovery After Surgery(ERAS)in perioperative application of pancreaticoduodenectomy(PD)

目的探究加速康复外科(ERAS)理念在胰十二指肠切除术(PD)围术期管理中的应用效果。方法选取吉林大学中日联谊医院肝胆胰外科收治的40例胰头癌或壶腹周围癌患者的临床资料。全部病人均行PD术,且由同一医疗组医生完成,将病人分为ERAS组(20例)和对照组(20例)。ERAS组采用ERAS观念指导下的围术期管理办法,对照组采用传统管理办法。两组比较一般情况(性别及年龄)、术后肠道功能恢复时间、术后住院时间、住院费用、术后相关并发症的发生率等各项指标,并进行统计学分析。结果两组患者一般情况(性别和年龄)相比较无明显差异(P>0.05)。与对照组对比,ERAS组患者术后肠道功能恢复的时间更早(P<0.01),住院时间缩短(P<0.01),住院费用更少(P<0.01),术后总并发症发生率更低(P<0.05)。结论ERAS理念在PD术围手术期管理中的应用是安全且有效的,肠道及其他脏器功能恢复更快,术后并发症的发生率降低,住院时间缩短,住院费用减少,病人整体的康复进程得以加快,ERAS在PD术围术期管理中的应用意义重大,值得推广。

Objective To investigate the Enhanced Recovery After Surgery(ERAS)concept is applied to the effect of perioperative management of pancreaticoduodenectomy(PD).Methods Analyze the case clinical data of 40 patients admitted in hospital routine of pancreaticoduodenal resection in China-Japan Union Hospital of Jilin University.Patients of pancreaticoduodenal resection,according to random number table method divided the patients into ERAS group(20 cases)and control group(20 cases).ERAS group guided by the idea of using ERAS perioperative management measures,the control group with traditional perioperative management measures.Compared the two groups of gender,age,postoperative intestinal function recovery time,length of postoperative hospital stay and cost,the incidence of complications such as the indicators,and statistical analysis.Results Comparing the two groups of gender,age,there are no significant difference(P>0.05).Compared with the control group,patients in ERAS group has been with postoperative intestinal function recovery time earlier(P<0.01)and shorter postoperative hospital stay(P<0.01),lower hospitalization expenses(P<0.01),postoperative liver function recovery faster(P<0.05),lower incidence of postoperative complications(P<0.05).Conclusion ERAS concept application in the perioperative management of pancreaticoduodenal resection is safe and effective,that can decrease the incidence of postoperative complications,and accelerate rehabilitation process of patients.ERAS in PD surgery perioperative management is of great significance to the application,is worth promoting.