围手术期营养支持治疗在急腹症加速康复中的应用

Perioperative nutritional support of patients with acute abdomen in enhanced recovery after surgery programme

目的评价围手术期营养支持治疗在应用加速康复外科理念救治急腹症患者过程中的应用价值。方法收集2015年3月至2016年3月郑州大学第一附属医院急诊外科收治因急腹症入院并行手术患者的临床资料，分为加速康复外科组（enhanced recovery after surgery，ERAS组，287例）和传统围手术期管理组（conservative perioperative management，CPM组，203例），术前进行NRS2002营养风险评估。比较两组患者相关生化指标和临床指标。结果与CPM组相比，ERAS组各疾病患者术后血浆白蛋白、前白蛋白水平均明显改善，差异有统计学意义（P〈0.05），术后WHO疼痛分级降低，肠功能恢复快，并发症发生率降低，住院时间缩短。结论急腹症患者经围手术期营养支持，应用加速康复外科策略可有效促进患者术后康复，改善患者临床结局。

Objective To evaluate perioperative nutritional support for patients with acute abdomen in enhanced recovery after surgery （ ERAS ） programme. Methods A total of 490 patients with acute abdominal disease were collected, 287 in ERAS group and 203 in conservative perioperative management （CPM） group. Biochemical and clinical markers of the 2 groups were compared. Results ERAS group had higher plasma albumin level, quicker bowel function recovery, lower postoperative complications, shorter hospital stay, and a lower WHO pain rating scale （ all P 〈 0. 05 ）. Conclusion With perioperative nutritional support, ERAS programme can accelerate recovery after emergency surgery, reduce the rate of overall complications, promote bowel function recovery, and decrease morbidity in the perioperative period for patients with acute abdominal disease.