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泌尿外科患儿非选择性围手术期加速康复外科管理回顾性研究 被引量:5

Retrospective study of perioperative enhanced recovery after surgery management unselectively in children with urological diseases
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摘要 目的探讨非选择性加速康复外科(enhanced recovery after surgery,ERAS)管理策略在泌尿外科患儿围手术期应用的安全性、可行性和有效性。方法回顾性分析中山大学附属第六医院泌尿外科2018年7月至2018年12月收治的142例泌尿患儿非选择性围术期ERAS管理的临床资料。其中,男134例,女8例;年龄为(5.05±3.63)岁,范围在14 d~14岁。手术方式包括开放手术68例(47.9%),腹腔镜手术55例(38.7%),泌尿腔道内镜手术19例(13.4%);三、四级手术122例(85.9%)。收集患儿围手术期资料,分析患儿术后住院时间、首次大便时间、术后当天(D0)饮食、D0离床活动、术后并发症等一般情况。结果患儿术后当天(D0)出院12例(8.5%),术后第1天(D1)出院74例(52.1%),术后住院时间为(1.94±2.02)d;首次大便时间(0.46±0.57)d;D0恢复饮食141例(99.3%);D0离床活动138例(97.2%);非计划手术0次;30天再入院5例;术后整体并发症发生率为7.7%(11/142),其中Clavien-Dindo分级Ⅰ级5例(3.5%)、Ⅱ级6例(4.2%),无Ⅲ、Ⅳ、Ⅴ级并发症。结论在泌尿外科小儿患者非选择性实施围术期ERAS管理是安全可行的,有助于患儿更快恢复。 Objective To explore the safety and efficacy of perioperative enhanced recovery after surgery(ERAS)management unselectively in children with urological diseases.Methods From July 2018 to December 2018,clinical data were retrospectively reviewed for 142 children unselectively receiving perioperative ERAS management.There were 134 boys and 8 girls with a median age of(5.05±3.63)(14/365-14)years.Surgical approaches included open(n=68),laparoscopic(n=55)and endoscopic(n=19).There were 122 gradeⅢ/Ⅳoperations(85.9%).Perioperative data were collected.Postoperative length of stay,initial defecation time,postoperative complications and recovery time of diet and activity were recorded.Results Twelve(8.5%)and 74(52.1%)children were discharged on postoperative day 0 and 1 respectively.The average postoperative length of stay was(1.94±2.02)days.And the initial defecation time was(0.46±0.57)days.And 138(97.2%)and 141(99.3%)children resumed oral intake and ambulated immediately.There were no unplanned re-operations.Five were readmitted within 30 days postoperatively(3.5%).The causes included wound infections(n=3)and urinary tract infections(n=2).Clavien-Dindo gradeⅠ/Ⅱcomplications were observed in 5(3.5%)and 6(4.2%)cases.There was no gradeⅢ/Ⅳ/Ⅴcomplication.Conclusions Perioperative ERAS management is both safe and feasible during unselective applications for pediatric urological diseases.It may facilitate a faster recovery.
作者 尧冰 王德娟 栗霞 韦丽娜 瞿虎 钟文文 林武剑 高旻 汪中扬 邱剑光 Yao Bing;Wang Dejuan;Li Xia;Wei Lina;Qv Hu;Zhong Wenwen;Lin Wujian;Gao Min;Wang Zhongyang;Qiu Jianguang(Department of Urology,Sixth Affiliated Hospital,Sun Yet-sen University,Guangzhou 510655,China;Department of Rehabilitation,Sixth Affiliated Hospital,Sun Yet-sen University,Guangzhou 510655,China)
出处 《中华小儿外科杂志》 CSCD 北大核心 2021年第9期799-802,共4页 Chinese Journal of Pediatric Surgery
基金 广东省医学科学基金(A2019347)。
关键词 儿童 泌尿外科学 加速康复外科 围手术期 Child Urology Enhanced recovery after surgery Perioperative period
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