加速康复外科在上消化道穿孔围术期的应用价值

Application value of enhanced recovery after surgery in perioperative period of upper digestive tract perforation

目的探讨加速康复外科(ERAS)在上消化道穿孔围术期的应用价值。方法选取2016年1月~2018年10月于南方医科大学南海医院胃肠外科住院的上消化道穿孔并行穿孔修补术的80例患者作为研究对象,按照随机数字表法将其分为实验组和对照组,每组各40例。对照组患者采用传统的围术期处理措施,实验组患者采用ERAS措施。比较两组患者的术后首次排气时间、住院时间、住院费用及并发症总发生率。结果实验组患者的术后首次排气时间为(52.0±15.7)h,短于对照组的(64.7±20.9)h,差异有统计学意义(P<0.05)。实验组患者的住院时间为(5.7±1.2)d,短于对照组的(8.0±1.9)d,住院费用为(12126.7±1434.1)元,低于对照组的(14778.2±2516.4)元,差异有统计学意义(P<0.01)。实验组患者的并发症总发生率为5.0%,显著低于对照组的20.0%,差异有统计学意义(P<0.01)。结论ERAS可促进术后恢复,减少术后并发症的发生,缩短住院时间,降低住院费用,应用于上消化道穿孔围术期安全有效。

Objective To explore the application value of enhanced recovery after surgery (ERAS) in the perioperative period of upper digestive tract perforation. Methods Eighty patients with upper gastrointestinal perforation and undergoing perforation repair in the Department of Gastrointestinal Surgery of Southern Medical University Nanhai Hospital from January 2016 to October 2018 were selected as subjects. They were divided into experimental group and control group according to the random number table method, 40 cases in each group. Patients in the control group were given conventional perioperative measures, and patients in the experimental group were given ERAS measures. The first postoperative exhaust time, hospitalization time, hospitalization cost, and total incidence rate of complications were compared between the two groups. Results The first postoperative exhaust time of the experimental group was (52.0±15.7) h, which was shorter than that of the control group for (64.7±20.9) h, and the difference was statistically significant (P<0.05). The hospitalization time of the experimental group was (5.7±1.2) d, which was shorter than that of the control group for (8.0±1.9) d, and the hospitalization cost was (12 126.7±1434.1) yuan, which was lower than that of the control group for (14 778.2±2516.4) yuan, with statistically significant differences (P<0.01). The total incidence rate of complications in the experimental group was 5.0%, which was significantly lower than that in the control group (20.0%), and the difference was statistically significant (P<0.01). Conclusion ERAS can promote postoperative recovery, reduce postoperative complications, shorten hospitalization time, and reduce hospitalization cost, which is safe and effective for perioperative period of upper gastrointestinal perforation.