加速康复外科配合经脐单孔腹腔镜对卵巢囊肿剥除术的应用效果评价

Evaluation of effect on ovarian cyst removal by laparoendoscopic single site surgery and enhanced recovery after surgery

目的探讨加速康复外科(ERAS)配合经脐单孔腹腔镜(LESS)对卵巢囊肿剥除手术的应用效果评价。方法选择2015年6月-2017年6月因卵巢良性囊肿在滨州医学院烟台附属医院妇科行LESS和传统方式腹腔镜进行卵巢囊肿剥除手术的患者各40例,纳入研究的患者均采用ERAS理念进行围手术期护理。将LESS患者设为实验组,传统方式腹腔镜手术患者设为对照组,比较两组患者手术时间、术中出血量、术后下床时间、术后排气时间、术后排大便时间,术后发热和感染等并发症发生率,住院时间和住院费用等指标。计量资料采用t检验,计数资料采用χ~2检验,以P<0.05为差异有统计学意义。结果实验组在术后下床时间、术后排气时间、术后排大便时间、住院时间均较对照组缩短,住院费用较对照组降低,两组比较差异均有统计学意义(P<0.05);手术时间、术中出血量、术后并发症发生率与对照组比较无明显差异,两组比较差异无统计学意义(P>0.05)。结论 ERAS配合LESS利于康复、缩短住院时间、减少住院费用,值得临床推广和应用。

Objective To evaluate the effect on removal of ovarian cyst by laparoendoscopic single site surgeryand enhanced recovery after surgery （ERAS）. Methods A prospective, single-institution study was performed forpatients who were diagnosed benign ovarian cyst, underwent removal ovarian cyst, and adopted ERAS nursing carefrom June 2015 to June 2017. 40 patients who adopted laparo-endoscopic single site surgery were experimentalgroup and 40 patients who adopted traditional laparoscopy surgery were control group. We compared the operationtime, blood loss volume during operation, the time of getting out-of bed after operation, the postoperative exhaustingtime, the defecation time after surgery, the incidence of postoperative febrile and other complications, the time ofhospital stay, and hospitalization expenses between the two groups. The measurement data was tested by t test,and the counting data was tested by χ2 test, which was statistically significant with P 〈 0.05. Results The resultsshowed that the time of getting out-of bed after operation, the postoperative exhausting time, the defecation timeafter surgery and the time of hospital stay in experimental group was significantly shorter than the control group;Meanwhile the hospitalization expense was lower than the control group. These results were statistically significant（P 〈 0.05）. While there was not statistically significant in the operation time, blood loss volume during operation, and the incidence of postoperative febrile and other complications between the experimental group and the control group（P 〉 0.05） . Conclusion ERAS combined with laparo-endoscopic single site surgery is helpful to the reduction ofhospitalization cost and the clinical promotion and application.