加速康复外科理念用于混合痔日间手术的效果观察

Application of ERAS concept in day surgery for mixed hemorrhoids

目的探讨加速康复外科(ERAS)理念在混合痔日间手术患者围术期应用的效果。方法将拟行混合痔日间手术治疗的532例患者随机分为ERAS理念指导组(266例)和常规日间手术组(266例)。比较两组患者术后不同时间点手术切口视觉模拟法(VAS)疼痛评分、总住院费用、住院时间、术后并发症和患者满意度评分、未入院率、延迟出院率及非计划再次入院率。结果两组患者不同时间点手术切口VAS疼痛评分、术后并发症发生情况比较差异均无统计学意义(均P>0.05)。ERAS理念指导组患者总住院费用、住院时间均少于常规日间手术组,患者满意度评分高于常规日间手术组,差异均有统计学意义(均P<0.05)。ERAS理念指导组患者的未入院率、延迟出院率及非计划再次入院率均低于常规日间手术组,差异均有统计学意义(均P<0.05)。结论ERAS理念围术期干预混合痔日间手术能够减少患者总住院费用、住院时间,提高患者满意度,降低患者未入院率、延迟出院率及非计划再次入院率,值得临床采用。

Objective To evaluate the efficacy of the concept of enhanced recovery after surgery(ERAS)applied in perioperative care for patients with mixed hemorrhoids receiving day surgery.Methods Total 532 patients with mixed hemorrhoids treated by day surgery were randomly assigned to ERAS concept guided group(266 cases)and routine day surgery group(266 cases).Visual analog scale(VAS)pain score at different time points after surgery,hospitalization expenses,length of hospital stay,postoperative complications,patients'satisfaction,rates of non admission,delayed discharge and unplanned readmission were documented and compared between the two groups.Results There were no significant differences in VAS pain scores after surgery and postoperative complications between two groups(both P>0.05).The hospitalization expenses,length of hospital stay were significantly decreased;patients'satisfaction was significantly increased;and rates of non-admission,delayed discharge and unplanned readmission were in the ERAS concept guided group were decreased,compared with the routine day surgery group(all P<0.05).Conclusion Application of ERAS concept in day surgery for mixed hemorrhoids can decrease hospitalization expenses,length of hospital stay and increase patients'satisfaction,can also decrease rates of non-admission,delayed discharge and unplanned readmission.