快速康复外科在肝脏右后叶切除中的应用研究

Research on the application of enhanced recovery after the right posterior lobectomy of liver

目的探讨快速康复外科(ERAS)模式,在肝右后叶切除术的患者中应用的安全性和有效性。方法收集2020—2021年同济大学附属东方医院和吉林省肝胆病医院行肝右后叶占位切除术的病历资料共60例,其中ERAS组和对照组各30例。比较两组患者的一般资料、术后住院时间、手术中出血量、围手术期肝脏相关指标、术后并发症、30 d内死亡率、围手术期再手术发生情况、90 d内死亡率、住院总费用及术后患者疼痛程度、患者满意度等资料,并进行综合评估。结果两组数据在性别、年龄、疾病诊断、术后并发症发生率均相近(均P>0.05)。ERAS组在术后住院天数、术后引流管拔除天数、早期饮食及活动、患者手术切口疼痛感受度及患者满意度均优于对照组(均P<0.05)。术后并发症两组间相近(P>0.05)。结论ERAS措施可以安全有效地缓解应激反应,提高患者住院满意度,减少住院天数,加速患者术后康复,同时不增加术后并发症发生率。

Objective To explore the safety and efficacy of ERAS(enhanced recovery after surgery)in the surgical treatment in the right posterior lobe of the liver.Methods The clinical data of the right posterior hepatic lobectomy performed in the East Hospital Affiliated to Tongji University and Jilin Hepatobiliary Disease Hospital from January 2019 to March 2021 were collected.ERAS was performed in 30 cases,while the other 30 cases received traditional method as control.The perioperative data such as intraoperative blood loss,liver function,complication,perioperative mortality within 30 days,hospital stay,re-surgery within 90 days,mortality,total cost and satisfaction were compared and comprehensively assessed.Results No significant differences in gender,age,disease diagnosis and incidence of postoperative complications between the two groups(all P>0.05).The ERAS group showed significant improvement in postoperative hospitalization days,postoperative drainage tube removal days,early food-taking and out-of-bed activity(all P<0.05).The perception of surgical incision pain was low and the satisfaction was higher in ERAS group.No significant difference in postoperative complications between the two groups(P>0.05).Conclusions ERAS can safely and effectively relieve stress reaction,improve inpatient′s satisfaction,reduce hospital stay,accelerate patients′postoperative rehabilitation,and do not increase the incidence of postoperative complications.