加速康复外科理念在宫颈癌根治术中的应用

Application of Enhanced Recovery After Surgery Management in Cervical Cancer Patients Undergoing Radical Hysterectomy

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念对于宫颈癌根治术围术期的影响。方法回顾性分析2017年5～12月ⅠB1～ⅡA2期宫颈癌46例资料,2017年9月前应用传统围术期管理方法(传统组,n=24),以后应用ERAS理念行围术期管理方法(ERAS组,n=22),比较2组术后排气时间、术后疼痛评分、术后住院时间等指标。结果 ERAS组术后排气时间[(57.7±7.9) h]短于传统组[(68.9±23.5) h,t=-2.199,P=0.036],术后即刻、6 h、24h及48 h疼痛评分(4.1±0.6,3.6±0.5,2.9±0.5,2.4±0.5)均小于传统组(5.1±0.7,4.0±0.6,3.5±0.6,2.9±0.7,t=-5.031、-2.681、-4.345、-2.730,P=0.000、0.010、0.000、0.009),ERAS组术后住院时间[(7.1±0.8) d]短于传统组[(9.7±5.2) d,t=-2.440,P=0.022]。结论 ERAS理念应用于宫颈癌根治术,可以促进术后胃肠功能的恢复,减轻术后疼痛,缩短住院时间,对宫颈癌根治术后康复起到积极促进作用。

Objective To explore the effect of enhanced recovery after surgery ( ERAS) on the cervical cancer patients undergoing radical hysterectomy.Methods A retrospective study of 46 cases of cervical cancer in stage ⅠB1 -ⅡA2 from May to December 2017 was conducted.Traditional perioperative management method was applied before September 2017 ( traditional group, n = 24),and ERAS management was applied after September 2017 ( ERAS group,n = 22).Postoperative exhaust time,postoperative pain scores,postoperative hospitalization days and other indicators were compared between the two groups.Results The postoperative exhaust time of the ERAS group was shorter than that of the traditional group [( 57.7 ± 7.9) h vs.( 68.9 ± 23.5) h, t =- 2.199,P = 0.036].The immediate,6 h,24 h and 48 h postoperative pain scores of the ERAS group ( 4.1 ± 0.6,3.6 ± 0.5, 2.9 ± 0.5,and 2.4 ± 0.5) were lower than those of the traditional group ( 5.1 ± 0.7,4.0 ± 0.6,3.5 ± 0.6,and 2.9 ± 0.7,t =- 5.031,- 2.681,- 4.345,and - 2.730,P = 0.000,0.010,0.000,and 0.009).Postoperative hospitalization days in the ERAS group was shorter than that in the traditional group [( 7.1 ± 0.8 ) d vs.( 9.7 ± 5.2 ) d,t =- 2.440,P = 0.022].Conclusion Enhanced recovery after surgery applied in the perioperative period of patients with cervical cancer can promote postoperative recovery of gastrointestinal function,reduce postoperative pain,shorten the hospitalization time,and play a positive role in promoting postoperative rehabilitation of patients with cervical cancer.