加速康复外科在上消化道穿孔围手术期的应用及展望

Application and prospect of enhanced recovery in upper gastrointestinal perforation perioperative period

目的:评价加速康复外科(ERAS)理念在上消化道穿孔围手术期的应用及展望。方法:回顾性分析2016-09—2017-08期间我院急诊外科收治的60例上消化道穿孔的患者,将其分为研究组与对照组。比较两组患者的各项临床指标及术后并发症的发生率。结果:两组患者两组患者在年龄、性别、手术时间、手术出血量、麻醉ASA分级比较,差异无统计学意义(P>0.05);而在术后手术时间、肠蠕动时间、首次下床活动时间、首次进食时间、术后拔除腹腔引流管时间、术后住院时间和术后观察切口感染、吻合口瘘、尿路感染及肺部感染等并发症发生情况均显著小于对照组(P<0.05)。结论:ERAS在急诊上消化道穿孔手术期中的应用效果确切,可明显改善机体各项机能,减少术后并发症,应用于上消化道穿孔救治是安全、有效的,值得临床进一步推广应用。

Objective：To evaluate the application and prospect of accelerated rehabilitation surgery（ERAS）in the perioperative period of upper digestive tract perforation.Method：Retrospective analysis of 60 patients with upper gastrointestinal perforation in our hospital from September 2016 to August 2017 was divided into the study group and the control group.The clinical indicators and the incidence of postoperative complications were compared between the two groups.Result：There was no statistically significant difference between the two groups in age,gender,operation time,surgical bleeding and ASA classification（P〈0.05）.In the operation time,postoperative bowel movements bed,the first time,for the first time to eat out time,postoperative abdominal drainage tube time,postoperative hospital stay,and postoperative incision infection,urinary tract infection and anastomotic fistula,happening lung infection and other complications were significantly less than the control group（P〈0.05）.Conclusion：Upper gastrointestinal perforation in ERAS Ed operation period effect is exact,the application of each function can obviously improve the body,reduce the postoperative complications,applied to the upper gastrointestinal tract perforation treatment is safe and effective,is worth further clinical application.