加速康复外科在Poland综合征患儿手畸形围手术期中的应用研究

Clinical application of enhanced recovery after surgery for perioperative management in children with Poland syndrome

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)应用于Poland综合征患儿手指矫形围手术期中的临床效果。方法将自2016年6月至2018年6月收治的35例Poland综合征患儿作为对照组,行传统围手术期管理模式;自2018年7月至2020年6月收治的35例Poland综合征患儿作为研究组,行加速康复外科管理模式。手术均一次性行2~5指并指分离术,统计两组患儿手术时间、麻醉时间、术后各时间段疼痛情况、术后不良反应发生情况、住院时间、住院费用以及家属满意度。结果研究组术后2、6、12 h的改良面部表情法(FLACC)疼痛评分明显低于对照组,且术后不良反应发生率低(P<0.05)。研究组相对于对照组的住院时间短、住院费用低、家属满意度高(P<0.05)。结论ERAS应用于Poland综合征患儿手指矫形围手术期管理,能降低围手术期疼痛指数,在减少术后不良反应发生的同时加速机体康复,从而达到缩短住院时间的目的,值得临床推广。

Objective To investigate the clinical efficacy of enhanced recovery after surgery(ERAS)in the perioperative period of finger correction in children with Poland syndrome.Methods From June 2016 to June 2018,35 cases of children with Poland syndrome were selected as the control group and treated with traditional perioperative management mode;from July 2018 to June 2020,35 cases of children with Poland syndrome were selected as the study group and treated with ERAS management mode.The second to fifth fingers were separated at one time.The operation time,anesthesia time,postoperative pain,postoperative adverse reactions,hospitalization time,hospitalization expenses and family satisfaction were recorded and analyzed statistically.Results The modified facial expression(FLACC)pain score of the study group was significantly lower than that of the control group at 2,6 and 12 hours after operation,and the incidence of postoperative adverse reactions was lower(P<0.05).Compared with the control group,the study group had shorter hospitalization time,lower hospitalization expenses and higher family satisfaction(P<0.05).Conclusion The application of ERAS in the perioperative management of finger correction in children with Poland syndrome can reduce the perioperative pain score,reduce the occurrence of postoperative adverse reactions and accelerate the recovery of the body,so as to shorten the length of hospital stay,which is worthy of clinical promotion.