加速康复外科理念在胆管空肠Roux-en-Y吻合术中的疗效分析

Analysis of the therapeutic effect of enhanced recovery after surgery in Roux-en-Y choledochojejunostomy

目的将加速康复外科理念(ERAS)运用于胆管空肠Roux-en-Y吻合术(CDJ)围术期管理,评价其安全性及可行性。方法回顾性分析2015年5月至2019年5月83例接受CDJ治疗的良性疾病患者资料。其中37例接受传统理念治疗(传统组);46例患者采用ERAS理念治疗(ERAS组)。运用SPSS 19.0软件进行分析。术中术后各项指标、VAS疼痛评分以(x±s)表示,采用独立t检验;术后并发症比较采用χ^2检验,Fisher确切概率法进行校正,P<0.05为差异有统计学意义。结果 ERAS组患者在术后各时间段VAS评分、肛门排气时间、下床活动时间、住院时间、住院费用、患者满意度评分等均优于传统组(P<0.05);ERAS组患者总并发生发生率(8.7%)明显低于传统组(27.0%),差异具有统计学意义(P<0.05)。结论将ERAS理念应用于CDJ中,有效减轻患者术后疼痛,确保术后快速康复,同时减少患者住院期间的医疗费用,提高了患者对诊疗过程的满意度。

Objective To apply enhanced recovery after surgery(ERAS) model in perioperative period of Roux-en-Y choledochojejunostomy(CDJ) and evaluate its safety and feasibility. Methods The clinical data of 83 patients with benign diseases treated by CDJ from May 2015 to may 2019 were retrospectively collected and analyzed. They were divided into two groups according to the treatment concept they received, with 37 patients in the traditional group and 46 patients in the ERAS group. Statistical analysis was preformed with Spss 19.0 software. Postoperative indexes,VAS scores were expressed by (x±s), and compared with independent t-test;Postoperative complications were compared by χ^2 test, Fisher exact probability method was used for correction, P<0.05 was statistically significant.Results The result of VAS scores, the time of anal exhaust and off-bed, hospital stays, total costs of hospitalization and patient satisfaction in ERAS group were all better than those in the traditional group(P<0.05). And the total incidence of complications in ERAS group(8.7%) was significantly lower than that in the traditional group(27.0%). Conclusions The value of ERAS applied to CDJ patients is good for quick recovery, higher satisfaction, lower pain and hospitalization costst.