加速康复外科在妇科腹腔镜围术期的应用

Application of enhanced recovery after surgery in laparoscopic gynecological surgery

目的探讨加速康复外科(ERAS)在行妇科腹腔镜手术的患者围术期的应用价值。方法选择2018年10月至2019年3月在该院因妇科良性疾病住院行腹腔镜微创手术治疗的患者182例,随机分为两组:分别采用ERAS围术期处理(观察组)和采用传统方法围术期处理(对照组),比较两组患者手术时间、术中出血量、术后恶心呕吐、炎症介质变化、肛门排气恢复时间、住院时间、住院费用及手术并发症。结果观察组与对照组相比,手术时间、术中出血量差异无统计学意义(P>0.05);观察组术后恶心呕吐的发生及腹泻、腹胀并发症均少于对照组,术后肛门排气恢复时间早于对照组,住院时间及住院费用少于对照组,两组比较差异均有统计学意义(P<0.05);观察组术后炎症介质升高程度明显低于对照组,差异有统计学意义(P<0.05)。结论妇科良性疾病患者行腹腔镜微创手术采用ERAS进行围术期处理,有助于减轻患者术后炎性反应,利于术后恢复,可缩短住院时间,降低住院费用,值得在妇科腹腔镜手术中进行推广。

Objective To explore the application value of enhanced recovery after surgery(ERAS)during perioperative period in the patients undergoing gynecologic laparoscopic surgery.Methods One hundred and eighty two inpatients undergoing gynecological laparoscopic minimally invasive surgery due to gynecological benign diseases in this hospital from October 2018 to March 2019 were selected and randomly divided into the two groups:adopting ERAS perioperative treatment(observation group)and adopting the conventional method perioperative treatment(control group).The operation time,intraoperative blood loss volume,postoperative vomiting and nausea,postoperative anal exhaust time,inflammatory mediators changes,hospital stay,hospitalization costs,and surgical complications were compared between the two groups.Results There was no statistically significant difference in the operation time and intraoperative blood loss volume between the observation group and the control group(P>0.05).Postoperative nausea and vomiting occurrence,and complications of diarrhea and abdominal distension in the observation group were less than those in the control group.Postoperative anal exhaust recovery time was earlier than that in the control group.The hospitalization stay and hospitalization costs were less than those in the control group,and the differences were statistically significant(P<0.05).The increased degree of inflammatory mediators in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Adopting ERAS for conducting the perioperative treatment in the patients with gynecological benign diseases undergoing laparoscopic minimally invasive surgery is conducive to reduce postoperative inflammatory reactions and postoperative recovery,shortens the hospitalization time,reduces the hospitalization costs and is worthy of promotion in gynecological laparoscopic surgery.