加速外科康复与舒适医疗在前列腺电切术中的应用

APPLICATION OF ENHANCED RECOVERY AFTER SURGERY AND COMFORTABLE MEDICAL CARE IN THE MANAGEMENT OF PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE

目的探讨加速外科康复与舒适医疗理念指导下程序化干预措施应用于经尿道前列腺电切术(TURP)围手术期及术中管理的效果。方法选取拟行TURP前列腺增生病人136例,随机分为两组,干预组66例,采用结构性程序化的加速外科康复与舒适医疗;对照组70例,采用常规治疗和操作。比较两组术中相关指标(包括手术时间和术中出血)和术后相关变量(包括术后膀胱过度活动症评分、进食时间、输液天数、胃肠恢复时间、导尿管拔除时间、住院天数、住院费用)。结果干预组手术时间和术中出血量明显低于对照组,差异有显著性(t=2.59、2.94,P<0.05);术后膀胱过度活动症评分、进食时间、输液天数、胃肠恢复时间、导尿管拔除时间、住院天数、住院费用均明显低于对照组,差异有统计学意义(t=4.53~9.60,P<0.05)。结论采用加速外科康复与舒适医疗理念指导下采取结构性程序化干预措施,加强TURP围手术期及术中管理,利于病人术后康复。

Objective To investigate the application of procedural intervention guided by the concepts of enhanced recovery after surgery（ERAS）and comfortable medical care in the perioperative and intraoperative management of patients undergoing transurethral resection of the prostate（TURP）. Methods A total of 136 patients who planned to undergo TURP were randomly divided into intervention group with 66 patients（procedural ERAS combined with comfortable medical care）and control group with70 patients（routine treatment and surgical operation）.The two groups were compared in terms of intraoperative indices（including time of operation and intraoperative blood loss）and postoperative indices（including Overactive Bladder Symptom Score（OABSS）,time to eat,number of days of infusion,time to gastrointestinal recovery,time to removal of urinary catheter,length of hospital stay,and hospital costs）. Results The intervention group had a significantly shorter time of operation and a significantly lower intraoperative blood loss than the control group（t=2.59,2.94;P0.05）.Compared with the control group,the intervention group had a significantly lower OABSS,significantly shorter time to eat,time to gastrointestinal recovery,and time to removal of urinary catheter,a significantly lower number of days of infusion,a significantly shorter length of hospital stay,and significantly lower hospital costs（t=4.53-9.60,P0.05）. Conclusion Structural procedural intervention guided by the concepts of ERAS and comfortable medical care can enhance the perioperative and intraoperative management of patients undergoing TURP and help with the postoperative rehabilitation of such patients.