加速康复外科在腹腔镜胰十二指肠切除术围术期的应用效果

Application effect of enhanced recovery at perioperative period of laparoscopic pancreaticoduodenectomy

目的探讨加速康复外科(ERAS)在腹腔镜胰十二指肠切除术(LPD)围术期的应用效果。方法回顾性分析2013年7月~2017年3月广东省中医院收治的85例行LPD手术患者的临床资料,其中采用加速康复外科治疗措施的43例为ERAS组,采用传统围术期治疗措施的42例为对照组,比较分析两组术中及术后情况。结果两组手术时间、术中出血、再次手术情况、术后各并发症发生率及术后死亡率相比较,差异无统计学意义(P>0.05);与对照组比较,ERAS组患者术后排气时间更早,术后住院时间和总住院时间更短,术后并发症的总发生率更低,差异有统计学意义(P<0.05或P<0.01)。结论 ERAS在腹腔镜胰十二指肠切除术围术期的应用是有效并且安全的。

Objective To study the application effect of enhanced recovery after surgery （ERAS） for laparoscopic pancreatoduodenectomy （LPD） patients.Methods From July 2013 and March 2017,in Guangdong Provincial Hospital of Traditional Chinese Medicine,the clinical data of 85 patients who underwent LPD were analyzed retrospectively.The 43 patients treated with ERAS measures were as ERAS group,and the 42 treated with conventional program were as control group.The intraoperative and postoperative situation were compared.Results There was no statistically significant dif ference in operation time and operative blood loss,rates of special complication,the operative mortality and relaparotomy in two groups （P 〉 0.05）.Comapred with control group,the time of postoperative first flatus was earlier,postoperative length of stay and total length of stay were less,rate of overall complication was less in ERAS group,the differences were statistically significant （P 〈 0.05 or P 〈 0.01）.Conclusion The ERAS pathway is effective and safe for LPD patients.