加速康复外科在混合痔患者围手术期的应用效果

Efficacy of Enhanced Recovery Surgery Applied at Perioperation of Mixed Hemorrhoids Patients

为探讨加速康复外科(ERS)在混合痔患者围手术期的应用效果,将4216例混合痔手术患者随机分为ERS组和传统组,每组2108例,ERS组于ERS模式下进行围手术期处理,传统组进行传统的围手术期处理。比较2组术后疼痛评分(VAS)、医院焦虑抑郁量表(HADS)评分、术后并发症发生率、住院时间、恢复正常生活时间、日常生活能力评定Barthel指数评分、30d内再入院率等。结果显示,ERS组术后1d、2d、3d和7d疼痛评分,明显低于传统组(P<0.001);ERS组术前、术后1d和7dHADS评分明显低于传统组(P<0.001);ERS组术后尿潴留、大便嵌塞、肛缘水肿、创面延迟愈合发生率低于传统组(P<0.05),术后大出血、肛门直肠狭窄、肛门失禁、感染发生率2组比较差异无统计学意义(P>0.05)。ERS组术后住院时间、恢复正常生活时间短于传统组,Barthel指数评分高于传统组(P<0.05),30d内再入院率2组之间无明显差异(P>0.05)。结果表明,加速康复外科用于混合痔患者围手术期效果确切,可缩短患者恢复时间,提高患者满意度。

This study was to investigate the efficacy of enhanced recovery surgery(ERS)applied at perioperation of mixed hemorrhoids patients,randomly divided 4216 cases undergoing surgery into ERS group(2108 cases,perioperative management according to ERS mode)and routine group(2108 cases,routine perioperative management);then,compared postoperative VAS rating of pain,HADS rating,postoperative complication incidence,hospitalization time,the time for orthobiosis recovered,Barthed Index score rating(to evaluate daily viability),and readmitted rate,and so on between the two groups.As results,1,2,3 and 7 days after surgery ERS groups’pain rating was significantly lower than routine groups’one(P<0.001);before surgery and 1,7 days after surgery ERS groups’HADS rating was significantly lower than routine group’s one(P<0.01);after surgery the incidence of urochesis,feces impaction,ano-edge edema,and delayed healing of wound-surface in ERS group were lower than that in routine group(P<0.05);in the incidence of postoperative massive bleeding,ano-rectal stenosis,anal incontinence,and infection there was no statistical difference between the two groups(P>0.05);in postoperative hospitalization time,in the time for orthobiosis recovered;and in Barthed index score rating ERS group was shorter,and higher than routine group(all,P<0.05);in readmitted rate within 30 days there was no statistical difference between the two groups(P>0.05).Results show that ERS applied at perioperation of mixed hemorrhoids patients has certain efficacy,can shorten the time of patients recovered,enhance patients’satisfactory degree.