基于ERAS理念下胆囊切除术围术期疼痛管理的效果探究

Research on the Effect of Perioperative Pain Management of Cholecystectomy Based on ERAS Concept

目的对胆囊切除术围术期疼痛管理中践行加速康复外科(enhanced recovery after surgery,ERAS)理念的临床效果进行探析。方法方便选取2018年7月—2019月7月在该院肝胆外科接受胆囊切除术治疗的104例患者,基于数字表法随机分成探究组和对照组,各52例;均行腹腔镜切除术,对照组围术期行常规疼痛管理,探究组行ERAS理念下疼痛管理,应用视觉模拟法(VAS)评价术后不同节点的疼痛度,并对比术后首次下床时间、排气恢复时间、首次进食时间及住院时间。结果探究组患者术后1、6、12、24、48 h的VAS评分分别为(4.65±1.04)分、(3.17±1.01)分、(2.91±1.92)分、(2.25±1.04)分、(1.54±0.48)分,对照组分别为(5.22±1.15)分、(4.03±1.15)分、(3.74±1.09)分、(3.02±1.15)分、(2.61±0.55)分,差异有统计学意义(t=5.300、5.273、4.088、6.102、4.322,P<0.05)。探究组首次下床时间、排气恢复时间、首次进食时间及住院时间分别为(6.28±1.25)h、(23.20±1.61)h、(18.25±1.72)h、(5.13±1.02)d,低于对照组的(9.10±2.08)h、(30.17±1.45)h、(22.65±1.29)h、(7.50±1.35)d,差异有统计学意义(t=7.358、8.229、6.283、10.152,P<0.05)。结论在胆囊切除术围术期开展基于ERAS理念疼痛管理,有助于减轻术后疼痛,促进患者康复,有助重要临床意义。

Objective To explore the clinical effects of practicing the concept of enhanced recovery after surgery(ERAS) in pain management during perioperative cholecystectomy. Methods Conveniently selected 104 patients who underwent cholecystectomy at the Department of Hepatobiliary Surgery in the hospital from July 2018 to July 2019. Based on the number table method, they were randomly divided into an exploratory group and a control group, 52 cases in each;all underwent laparoscopy after resection, the control group received routine pain management during the perioperative period,and the exploratory group received pain management under the ERAS concept. The visual simulation method(VAS) was used to evaluate the pain at different points after the operation, and the time to get out of bed for the first time after the operation and exhaust recovery time, time of first meal and length of hospital stay were compared. Results The VAS scores of patients in the exploratory group were(4.65 ±1.04)points,(3.17 ±1.01)points,(2.91 ±1.92)points, and(2.25 ±1.04) points,(1.54±0.48) points at 1 h, 6 h, 12 h, 24 h, and 48 h after surgery, the control group was(5.22±1.15)points,(4.03±1.15)points,(3.74 ±1.09)points,(3.02 ±1.15)points,(2.61 ±0.55)points, the difference was statistically significant(t =5.300, 5.273,4.088, 6.102, 4.322,P <0.05). The exploratory group’s first out of bed time, exhaust recovery time, first meal time and hospital stay were(6.28±1.25) h,(23.20±1.61)h,(18.25±1.72)h,(5.13±1.02)d, lower than the control group’s(9.10±2.08)h,(30.17±1.45)h,(22.65±1.29)h,(7.50± 1.35)d, the difference was statistically significant(t=7.358, 8.229, 6.283, 10.152, P<0.05). Conclusion Carrying out pain management based on the ERAS concept during the perioperative period of cholecystectomy can help reduce postoperative pain and promote rehabilitation of patients contributes to important clinical significance.