加速康复外科理念在膀胱癌患者围手术期中的应用价值

Application of enhanced recovery after surgery concept in perioperative management for patients with bladder cancer

目的探讨加速康复外科理念在膀胱癌患者围手术期中的应用价值。方法依据随机数字表法将70例膀胱癌患者分为观察组和对照组,每组35例。两组患者均接受腹腔镜膀胱癌切除术,观察组患者采用加速康复外科理念指导下的围手术期管理,对照组患者采用传统围手术期管理。比较两组患者的围手术期指标、视觉模拟评分法(VAS)评分及并发症发生情况。结果观察组患者的首次下床活动时间、首次排气时间、住院时间均短于对照组患者,住院费用少于对照组患者,差异均有统计学意义(P﹤0.05)。术后6、12、24、48h,观察组患者的VAS评分均明显低于对照组患者,差异均有统计学意义(P﹤0.01)。观察组患者的术后并发症总发生率为2.86%,低于对照组患者的22.86%,差异有统计学意义(P﹤0.05)。结论加速康复外科理念应用于膀胱癌患者的围手术期管理可促进患者术后康复,降低术后疼痛程度和并发症发生率。

Objective To explore the value of perioperative management following enhanced recovery after surgery (ERAS) concept for patients with bladder cancer.Method The analysis included 70 patients with bladder cancer who were randomized using a random number table to study group or control group,with 35 cases in each group.Both groups of patients were managed with laparoscopic resection of bladder cancer,while the study group was administered with procedures following ERAS concept,and the control group was given traditional perioperative management.The perioperative indicators,visual analogue scale (VAS) scores for pain evaluation,and complications were compared between the two groups.Result The first ambulation time,first flatus time,and length of hospitalization were all decreased in study group than in control group,additionally,less hospitalization expenses were generated in study group versus those in control group,the differences were statistically significant (P<0.05).In 6,12,24 and 48 h after surgery,the VAS score in study group were significantly lower than those of the control group (P<0.01).The incidence of postoperative complications was 2.86% in study group,which was also significantly lower compared to the 22.86% in control group (P<0.05). Conclusion ERAS concept as utilized in the perioperative management of bladder cancer patients promotes their postoperative recovery and reduces the degree of pain and incidence of complications.