加速康复外科在妇科腔镜手术中的应用体会

Application of enhanced recovery after surgery in gynecological laparoscopic surgery

目的:探讨加速康复外科(enhanced recovery after surgery,ERAS)策略用于妇科腔镜手术中的安全性与有效性。方法:将拟行腹腔镜妇科手术的200例患者随机分为ERAS组与对照组。ERAS组围手术期采用ERAS策略处理,对照组采用传统围手术期方案处理。术后2 h、6 h、12 h、24 h采用视觉模拟评分法观察两组患者疼痛程度,对比分析两组术后肛门首次排气时间、术后恶心呕吐发生率、术后住院时间、住院总花费及其他并发症发生情况。结果:与对照组相比,ERAS组术后2 h、6 h、12 h疼痛评分及术后恶心呕吐发生率明显降低(P<0.05);术后肛门首次排气时间缩短(P<0.05);术后住院时间、住院总费用减少(P<0.05)。两组患者术后其他并发症发生率差异无统计学意义。结论:ERAS策略可安全地用于妇科腔镜手术,能有效促进术后恢复、缩短住院时间、降低医疗费用。

Objective：To evaluate the safety and efficiency of enhanced recovery after surgery （ERAS） program used in gyne- cological laparoscopic surgery. Methods：Two hundred patients undergoing gynecologic laparoscopic surgery were randomly divided into two groups：ERAS group and control group. ERAS Group adopted ERAS strategy, control group adopted conventional therapy strategy. Postoperative pain was measured by visual analogue score at 2 h,6 h, 12 h, 24 h after surgery. First anal exhaust time, postoperative nausea and vomiting occurrence rate, postoperative hospital stay, total hospitalization expenditure and other complications were compara- tively analyzed. Results：Compared with control group, visual analogue score and nausea and vomiting occurrence rate at 2 h,6 h and 12 h after surgery was significantly reduced （ P 〈 0.05 ） ; first anal exhaust time, postoperative hospital stay and total expenses of hospitali- zation was less in ERAS group （P 〈 0.05 ）. There was no significant difference in other postoperative complications between the two groups. Conclusions：ERAS strategy can be used for gynecological laparoscopic surgery safely. It can effectively promote postoperative recovery, shorten hospital stay and reduce medical costs.