加速康复外科在机器人辅助肝切除病人中应用效果的研究

Application of fast track surgery in robotic-assisted laparoscopic liver resection

目的探讨加速康复外科在机器人辅助肝切除病人中的应用效果。方法方便抽样选取2016年1～12月行机器人辅助肝切除术的病人74例为对照组,选取2017年1月至2018年3月行加速康复外科(enhanced recovery after surgery,ERAS)的机器人辅助肝切除术病人67例为干预组。对照组给予常规处理措施,干预组病人给予加速康复外科的一系列措施。结果实施加速康复后病人的术后恢复速度加快,其中首次进食时间提前1.34 d、首次肛门排气时间提前0.64 d、首次排便时间提前0.72 d、首次下床活动时间提前1.5 d,术后住院天数缩短0.99 d,差异均有统计学意义(均P<0.05)。术后并发症的发生率差异无统计学意义(P>0.05)。结论 ERAS理念可在不增加术后并发症的前提下,促进机器人辅助肝切除病人的快速康复。

Objective To explore the application of fast track surgery in robotic-assisted liver resection.Methods A total of 74 patients undergoing robot-assisted hepatectomy were conveniently sampled for the control group and 67 for the intervention group.The control group was subjected to the routine treatment measures,while a series of optimal nursing measures according to the fast recovery concept and evidence-based medicine were conducted in the intervention group.Results The speed of postoperative recovery was accelerated after the implementation of enhanced recovery after surgery.As compared with the control group,the first feeding time was 1.34 days earlier,the first anus exhaust time was 0.64 days earlier,the first time of defecation was 0.72 days earlier,and the first time to get out of bed was 1.5 days advanced,and the postoperative hospital stay of 0.99 days was shortened in the intervention group.All of these differences were statistically significant（P〈0.05）.There was no statistically significant difference in postoperative complications between two groups（P〉0.05）.Conclusions Enhanced recovery after surgery can promote rapid recovery of robotic-assisted hepatectomy patients without increasing postoperative complications.