加速康复外科理念在腹腔镜卵巢囊肿剥除术患者中的应用效果

Clinical application and efficacy of the concept of enhanced recovery after surgery in laparoscopic ovarian cyst excision

目的探讨加速康复外科理念在卵巢囊肿患者围手术期的应用价值。方法选取2018年10月至2019年11月间阜新市第二人民医院收治的接受手术治疗的80例卵巢囊肿患者,按照围术期处理方案的不同进行分组,将采用加速康复外科理念(ERAS)处理方案的40例患者纳入观察组,将采用传统处理方案的40例患者纳入对照组。比较两组患者手术时间、术中出血量,术后排气、排便时间、疼痛评分、术后并发症发生率及住院时长。结果两组患者术中出血量及手术时间比较,差异无统计学意义(P<0.05)。观察组患者的术后首次排气时间、首次排便时间、首次下床活动时间和住院天数低于对照组患者,差异均有统计学意义(均P>0.05)。观察组患者术后并发症发生率为37.5%,低于对照组患者的57.5%,差异有统计学意义(P<0.05)。观察组患者术后6h、24h和48h的疼痛评分均低于对照组患者,差异均有统计学意义(均P<0.05)。结论卵巢囊肿患者术后采用加速康复外科理念干预,可降低患者术后疼痛,促进患者术后康复,提高患者生活质量和满意度,是安全有效的,具有临床推广价值。

Objective To explore the significance and application of enhanced recovery after surgery(ERAS)in laparoscopic ovarian cyst excision.Methods A total of 80 patients with ovarian cyst were selected as the study subjects at Fuxin Second People’s Hospital from October 2018 to November 2019.They were randomly divided into an observation group and a control group according to the perioperative management with 40 patients in each group.Patients in the observation group were given ERAS-guided management and patients in the control group were given conventional therapy.Operation time,intraoperative blood loss,post-operative exhaust,defecating time,pain score,post-operative complications and length of stay were compared between the two groups.Results There was no significant difference in the intraoperative blood loss and operation time between the two groups(P>0.05).The postoperative exhaust,defecation time,out-of-bed activity,and length of hospital stay were lower in the observation group than in the control group(all P<0.05).The incidence of postoperative complications was 37.5%in the observation group which was lower than 57.5%of the control group(P<0.05).The VAS scores in the observation group at 6 h,24 h,and 48 h after surgery were significantly lower than in the control group(all P<0.05).Conclusions It is safe and effective to give the ERAS concept-guided intervention,which can reduce postoperative pain,promote postoperative recovery,improve patients’quality of life and satisfaction in laparoscopic ovarian cyst excision,and deserves the clinical expansion.