加速康复外科理念在腹腔镜阑尾切除术中的应用体会

Application of the concept of enhanced recovery after surgery in laparoscopic appendectomy

目的探究加速康复外科理念(enhanced recovery after surgery,ERAS)在腹腔镜阑尾切除术中的应用效果。方法选取本院2017年4月至2019年12月收治的行腹腔阑尾切除术患者130例作为研究对象,随机分为观察组与对照组,每组65例。对照组行常规腹腔镜阑尾切除术,观察组在对照组基础上联合多学科综合理论引导下的ERAS干预,比较两组首次进食时间、首次排气时间、首次排便时间、首次下床时间、术后24 h疼痛评分、住院时间及术后并发症发生率。结果观察组术后首次进食时间、首次排气时间、首次排便时间、首次下床时间、住院时间均短于对照组(P<0.05);观察组术后24 h时疼痛评分、术后并发症发生率均低于对照组(P<0.05)。结论腹腔阑尾切除术在ERAS干预下,可减轻患者手术痛苦,缩短住院时间,促进术后恢复,减少术后并发症发生率,值得临床推广应用。

Objective To explore the application of the concept of enhanced recovery after surgery(ERAS)in laparoscopic appendectomy.Methods 130 patients with laparoscopic appendectomy admitted to our hospital from April 2017 to December 2019 were selected as the research subjects and theywere randomly divided into observation group and control group,with 65 cases in each group.The control group underwent routine laparoscopic appendectomy,and the observation group combined with ERAS intervention under the guidance of multidisciplinary comprehensive theory on the basis of the control group.The time of first eat,time of first exhaust,time of first defecate,time of first getting out of bed,pain score of 24 hours after operation,length of hospital stay and incidence of postoperative complications between the two groups were compared.Results The time to first eat,time of first exhaust,time of first defecate,getting out of bed and length of hospital stay in the observation group were shorter than those in the control group(P<0.05).The pain score at 24 h after surgery and the incidence of postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion With ERAS intervention,abdominal appendectomy can relieve patients'surgical pain,shorten hospital stay,promote postoperative recovery,and reduce the incidence of postoperative complications,which is worthy of clinical application.