基于QoR-15评分系统的加速康复外科模式在肝门部胆管癌术后患者中的应用

Application effect of enhanced recovery after surgery mode based on QoR-15 scoring system in patients after hilarcholangiocarcinoma

目的探讨基于15项恢复质量(QoR-15)量表的加速康复外科模式应用于肝门部胆管癌术后的临床价值。方法分析2016年1月至2020年1月于南京医科大学附属淮安第一医院进行肝门部胆管根治术的102例患者临床资料,按患者入院先后顺序分为观察组49例和对照组53例,其中观察组采用基于QoR-15评分系统的加速康复外科模式,对照组则为常规治疗组。比较两组患者术前、术中的基本资料,及术后住院时间、住院总费用、并发症、医疗满意度、术后恢复质量等方面,评价其临床价值。结果两组患者术前基本资料差异无统计学意义,具有可比性(P>0.05);在手术时间、术中出血量方面两组比较差异无统计学意义(P>0.05);观察组患者在术后住院时间、住院总费用、医疗满意度、并发症方面优于对照组,两组比较差异有统计学意义(均P<0.05);其中观察组在术后第3天、第7天QOR-15评分明显高于对照组(P<0.05)。结论于肝门部胆管癌术后应用基于QoR-15的加速康复外科模式可以有效缩短住院时间,减少住院费用,降低术后并发症及加快患者的康复,同时增进医患沟通。

Objective To explore the clinical value of enhanced recovery after surgery mode based on 15-item Quality of Recovery(QoR-15)scale after hilarcholangiocarcinoma.Methods Analysis of clinical data of 102 patients undergoing hilarcholangiocarcinoma in Huaian First People's Hospial of Nanjing Medical University from January 2016 to January 2020,according to the order of patients'admission,they were randomly divided into the observation group of 49 cases and the control group of 53 cases.The observation group adopted theenhanced recovery after surgery based on the QoR-15 scoring system,while the control group used conventional treatment.Compare the basic data of the two groups of patients before and during the operation,as well as the length of postoperative hospitalization,total cost of hospitalization,complications,treatment satisfaction,postoperative recovery quality.Results The basic data of the two groups of patients before surgery were not statistically significant and comparable(P>0.05);there was no statistical difference between the two groups in terms of surgical time and intraoperative blood loss(P>0.05);The observation group was superior to the control group in terms of postoperative hospitalization time,total hospitalization costs,treatment satisfaction,andcomplications(P<0.05);the postoperative recovery quality score of the observation group was significantly higher than that of the control group(P<0.05).Conclusions The application of QoR-15-based enhanced recovery after surgery mode after hilarcholangiocarcinoma can effectively shorten the length of hospital stay,reduce the cost of hospitalization,reduce postoperative complications and accelerate patient recovery,and improve treatment satisfaction.