手汗症日间胸腔镜手术实施加速康复外科管理的临床效果

Clinical effect of enhanced recovery after surgery(ERAS)management in daytime thoracoscopic sympathectomy for palmar hyperhidrosis

目的探讨手汗症日间胸腔镜手术实施加速康复外科(ERAS)管理的临床效果。方法选取日间手术模式下行胸腔镜下交感神经切断术治疗的手汗症患者164例,将2022-06至2023-04收治的78例患者纳入对照组,实施常规管理;将2023年5-12月收治的86例患者纳入干预组,实施ERAS管理。记录并对比两组手术指标、疼痛程度、并发症发生率及满意度。结果干预组和对照组各手术指标相比,差异无统计学意义;干预组术后24 h[4(4,4)分]、3 d[3(3,4)分]、7 d[2(2,3)分]的VAS评分均低于对照组术后24 h[5(4,5)分]、3 d[4(4,5)分]、7 d[4(4,4)分],差异有统计学意义(P<0.05);干预组总并发症发生率(18.6%)低于对照组(35.9%),差异有统计学意义(P<0.05);干预组患者满意度[(95.69±2.19)分]高于对照组[(93.31±3.73)分],差异有统计学意义(P<0.05)。结论ERAS管理日间模式胸腔镜下交感神经切断术治疗手汗症可减轻患者疼痛程度,减少并发症,提升患者满意度,值得推广应用。

Objective To investigate the clinical effect of enhanced recovery after surgery(ERAS)management in daytime thoracoscopic sympathectomy for palmar hyperhidrosis.Methods A total of 164 patients with palmar hyperhidrosis who underwent thoracoscopic sympathectomy were selected under day-care surgery,and 78 patients treated from June 2022 to April 2023 were included in the control group and received conventional management.A total of 86 patients treated from May 2023 to December 2023 were included in the intervention group and received ERAS management.Surgical indicators,pain scores,complication rates,and patient satisfaction were recorded and compared between the two groups.Results There were no statistically significant differences between the two groups(P>0.05).The VAS pain scores at 24 h[4(4,4)points],3 d[3(3,4)points],and 7 d[2(2,2)points]in the intervention group were lower than those in the control group at 24 h[5(4,5)points],3 d[4(4,5)points],and 7 d[4(4,4)points],with statistically significant differences(P<0.05).The overall complication rate in the intervention group(18.6%)was lower than that in the control group(35.9%),with statistically significant difference(P<0.05).The patient satisfaction score in the intervention group(95.69±2.192)was higher than that in the control group(93.31±3.732)(P<0.05).Conclusions ERAS management in daytime thoracoscopic sympathectomy for palmar hyperhidrosis can alleviate pain,reduce complications,and improve patient satisfaction,which is worthy of popularization and application.