快速康复外科理念在全腔镜食管癌手术围手术期护理中的应用

Application of enhanced recovery after surgery concept in the perioperative care of whole endoscopic esophageal cancer surgery

目的探讨快速康复外科(ERAS)理念的应用对全腔镜食管癌根治术患者呼吸功能、胃肠道功能、住院时间及住院费用的影响。方法选择2016年2月至2018年2月在扬州大学附属医院行全腔镜食管癌根治术的80例患者,随机分为2组,每组40例。ERAS组患者术前进行ERAS理念宣教、呼吸功能锻炼和术后早期鼻饲流质结合肠内营养;对照组仅进行常规入院宣教和护理指导,无术前ERAS理念宣教、呼吸功能锻炼和术后早期鼻饲流质。记录两组患者术后肺部并发症的发生数量、肠鸣音恢复和肛门排气时间、住院时间及住院费用。结果与对照组比较,ERAS组患者术后肺部并发症发生率显著降低,肠鸣音恢复与肛门首次排气时间、下床时间和住院时间均显著缩短,住院治疗费用也显著降低,差异均有统计学意义(P<0.05)。结论对于全腔镜食管癌根治术患者,ERAS理念指导可有效降低肺部并发症的发生率,胃肠道功能恢复时间更早,住院时间更短,住院费用也更低。

Objective To investigate the effect of the application of enhanced recovery after surgery concept （ERAS） on respiratory function, gastrointestinal function, length of hospital stay and hospitalization costs of patients undergoing radical resection of esophageal carcinoma.Methods Eighty patients undergoing whole endoscopic esophageal cancer surgery in the Affiliated Hospital of Yangzhou University from February 2016 to February 2018 were randomly selected and divided into 2 groups, i.e. ERAS group and control group, 40 in each group. The ERAS group received preoperative ERAS concept education, respiratory function training and early postoperative nasal fluid feeding combined with enteral nutrition; while the control group received only routine admission education and nursing guidance. The incidence of pulmonary complications, the recovery time of bowel sounds, the anus exhausting time, the length of hospitalization stay, and hospitalization costs were recorded in both groups.Results The incidence of pulmonary complications in ERAS group was much lower than that in control group （ P 〈 0.05 ）. The recovery time of bowel sounds, anus exhausting time, bed-out time, and length of hospitalization stay were much shorter in ERAS group. The hospitalization cost in ERAS group was much lower than that in control group （ P 〈0.05）.Conclusions For patients undergoing radical mastectomy for esophageal cancer, the ERAS concept can effectively reduce the incidence of pulmonary complications, and shorten the recovering time of gastrointestinal function, thus save hospitalization duration and costs.