应用每日目标管理路径指导胰腺术后患者早期经口进食的效果研究

The effects of applying daily goal management path to guide early oral feeding in patients after pancreatic surgery

目的:探讨应用每日目标管理路径指导胰腺术后患者早期经口进食的效果。方法:选择2019年1月至2020年12月北京市某三级甲等医院基本外科行择期/限期胰腺加速康复外科(Enhanced Recovery After Surgery,ERAS)手术的60例患者为实验组,采用每日目标管理路径指导胰腺术后患者早期经口进食;选择2017年1月至2018年12月行择期/限期胰腺ERAS手术的60例患者作为对照组,查阅病例进行回顾,比较两组患者术后胃肠功能恢复相关指标及术后并发症发生率。结果:实验组患者与对照组相比,术后胃排空障碍的发生率明显降低(P=0.038),术后恢复流食时间缩短(P=0.015),术后住院时间减少(P=0.024)。结论:在循证医学的基础上建立每日康复量化目标,可以激发患者完成术后快速康复目标的决心,帮助有效落实ERAS理念下的早期经口进食措施,促进胰腺术后患者胃肠功能恢复,缩短住院时间。

Objective:To explore the effects of using daily goal management to early oral feeding in patients after pancreatic surgery.Methods:We selected 60 patients undergoing elective/limited pancreatic ERAS surgery into the experimental group from Jan 1,2019 to Dec 31,2020 in the hospital,and using the daily goal management to guide their early oral feeding after surgery.In the control group,60 patients undergoing the same surgery were reviewed from Jan 1,2017 to Dec 31,2018.The outcome indexes of postoperative gastrointestinal function recovery and the incidence of postoperative complications were evaluated in the two groups.Results:Compared with the control group,the experimental group significantly reduced the incidence of postoperative gastric emptying disturbance,shortened the oral feeding time and reduced the postoperative hospital stay.There were statistical significance between the differences of the two groups(P<0.05).Conclusion:Establishing the quantitative goal of daily rehabilitation on the basis of evidence-based medicine can stimulate patients to better achieve the goal of rapid postoperative rehabilitation and effectively implement the early oral feeding measures of ERAS,promote the recovery of gastrointestinal function and shorten the hospitalization time of postoperative patients after pancreatic surgery.