基于ERAS理念的围手术期干预对开颅手术夹闭颅内前循环动脉瘤患者的效果

Effect of Perioperative Intervention Based on the ERAS Concept in Patients with Intracranial Anterior Circulation Aneurysm of Craniotomy Clipping

目的:分析基于快速康复外科(ERAS)理念的围手术期干预对开颅手术夹闭颅内前循环动脉瘤患者的效果。方法:选取2018年9月-2019年9月于深圳市中西医结合医院行开颅手术夹闭的颅内前循环动脉瘤患者61例,采用随机数表法分为对照组(31例)和观察组(30例),对照组围手术期予以常规护理,观察组围手术期予ERAS护理。比较两组胃肠道功能恢复情况、术后住院时间、住院费用、术后24 h视觉模拟疼痛评分(VAS评分)、出院时格拉斯哥预后评分(GOS评分)及术后并发症发生情况。结果:观察组术后首次肛门排气时间早于对照组,住院时间优于对照组,住院费用少于对照组(P<0.05);观察组术后24 h VAS评分显著低于对照组,出院时GOS评分显著高于对照组(P<0.05);观察组术后总并发症发生率显著低于对照组(P<0.05)。结论:基于ERAS理念的围手术期干预应用于开颅手术夹闭的颅内前循环动脉瘤可改善预后,加快胃肠功能恢复,减少术后住院时间及费用,降低术后并发症率。

Objective:To analyze the effect of perioperative intervention based on the concept of enhanced recovery after surgery(ERAS)in patients with intracranial anterior circulation aneurysm(IACA)of craniotomy clipping.Method:A total of 61 patients with IACA who underwent craniotomy in Shenzhen Integrated Traditional Chinese and Western Medicine Hospital from September 2018 to September 2019 were selected.Random number table method was used to divide the patients into the control group(31 cases)and the observation group(30 cases).The control group was given routine care during the perioperative period,and the observation group was given ERAS care during the perioperative period.Gastrointestinal function recovery,postoperative hospital stay,hospitalization cost,24 hour postoperative visual analog score(VAS)score,Glasgow outcomes score(GOS)score at discharge,and postoperative complications were compared between the two groups.Result:The first anal exhaust time in the observation group was earlier than that in the control group,the postoperative hospital stay was shorter than that in the control group,and the hospitalization costs was less than that in the control group(P<0.05).The 24 hour postoperative VAS score in the observation group was significantly lower than that in the control group,and the GOS score at discharge was significantly higher than that of the control group(P<0.05).The total incidence of postoperative complications was significantly lower in the observation group than that in the control group(P<0.05).Conclusion:The perioperative intervention based on the ERAS concept can be used to improve the prognosis in patients with IACA of craniotomy clipping,accelerate gastrointestinal function recovery,reduce postoperative hospitalization time and cost,and reduce postoperative complications.