加速康复外科在经脐单孔腹腔镜下输卵管切除术中的应用探讨

Use of enhance recovery after surgery protocol in single-port transumbilical single laparoscopic salpingectomy

目的探讨加速康复外科理念在经脐单孔腹腔镜下输卵管切除术患者围手术期的有效性和安全性。方法选择2018年1月至2019年3月在郑州大学第三附属医院因输卵管妊娠行经脐单孔腹腔镜下输卵管切除术的患者60例,随机分为两组(每组30例),实验组围手术期采用加速康复外科处理原则,对照组采用传统处理原则,比较观察两组患者术后恶心呕吐的发生、肛门排气的时间、住院时间、费用及术后的并发症。结果两组患者均痊愈出院,实验组与对照组相比,术后恶心呕吐的发生率23.3%,肛门排气时间(13.56±3.81)h、住院时间(3.06±0.50)d,治疗费用(6936.21±179.80)元,均明显低于对照组,差异有统计学意义(P<0.05)。两组患者手术并发症发生差异无统计学意义(P>0.05)。结论将加速康复外科理念用于单孔腹腔镜下输卵管切除术患者围手术期处理,可利于患者康复,缩短住院时间,降低住院费用,且不会增加手术并发症。

Objective To determine the efficacy and safety of enhanced recovery after surgery(ERAS)in patients undergoing single-port transumbilical laparoscopic salpingectomy during the perioperative period.Methods A total of 60 patients who underwent single-port transumbilical laparoscopic salpingectomy for Fallopian tube pregnancy in Third Affiliated Hospital of Zhengzhou University between January 2018 and March 2019 were randomly divided into two groups(n=30 each).During the perioperative period,the study group was given ERAS-based care,while the control group was given conventional care.The incidence of postoperative nausea and vomiting,time to anal exhaust,length of hospital stay,medical cost,and postoperative complications were recorded and compared between the two groups.Results The patients in both groups were cured and discharged subsequently.Compared with the control group,the incidence of postoperative nausea and vomiting was 23.3%,the time to anal exhaust was(13.56±3.81)h,the length of hospital stay was(3.06±0.50)d,and the medical cost was(6936.21±179.80)Yuan in the study group,which were significantly lower than those in the control group with statistically significant differences(P<0.05).The two groups did not differ significantly in surgery-related complications(P>0.05).Conclusion Use of ERAS protocol in perioperative caring for patients undergoing single-port transumbilical laparoscopic salpingectomy can be beneficial in terms of patient rehabilitation,shorter length of hospital stay,lower cost of hospitalization,and meanwhile,no increase in surgery-related complications.