加速康复外科在胃十二指肠巨大溃疡穿孔腹腔镜修补术的应用

Application of enhanced recovery after surgery in laparoscopic repair of giant gastroduodenal ulcer perforation

目的探讨加速康复外科(ERAS)在腹腔镜胃十二指肠穿孔修补术围手术期中应用的疗效及安全性。方法回顾性分析内蒙古自治区人民医院胃肠外科2015年2月至2019年2月间行腹腔镜治疗的132例巨大上消化道穿孔患者临床资料,根据围手术期有无联合ERAS处理,分为ERAS组(72例)和传统组(60例),比较两组患者术后恢复情况。结果与传统组相比,ERAS组患者术后胃肠功能恢复时间、首次正常进食时间及住院时间明显较短,围手术期负性情绪、术后C反应蛋白水平及并发症发生率显著较低,术后疼痛亦明显较轻(均P<0.05)。结论ERAS理念与腹腔镜技术结合能够有效促进巨大上消化道穿孔修补术患者的围手术期康复,并缩短住院时间。

Objective To explore the efficacy and safety of enhanced recovery after surgery(ERAS)in perioperative period of laparoscopic repair for gastroduodenal perforation.Methods The clinical data of one hundred and thirty-two patients with giant upper gastrointestinal perforation treated by laparoscopy from February 2015 to February 2019 in Inner Mongolia Autonomous Region People’s Hospital were retrospectively analyzed.According to whether ERAS was combined with perioperative treatment or not,they were divided into ERAS group(72 cases)and the traditional group(60 cases).The postoperative recovery was compared between the two groups.Results Compared with the traditional group,the recovery time of gastrointestinal function,the first normal eating time and hospitalization time of the patients in ERAS group were significantly shorter,and the negative mood during the perioperative period,the level of C-reactive protein and the incidence of complications after the operation were also significantly lower,and the pain after the operation was significantly lighter(P<0.05).Conclusion The combination of ERAS concept and laparoscopic technique can effectively promote the perioperative rehabilitation of patients with giant upper gastrointestinal perforation and shorten their hospital stay.