快速康复外科在压力性尿失禁围术期的临床应用

Clinical Effect of Fast Track Surgery in Perioperative Period of Stress Urinary Incontinence

目的:探讨快速康复外科在压力性尿失禁围术期的临床效果。方法:采用回顾性研究方法,选择2019年6月至2020年5月郑州大学附属郑州市中心医院收治的压力性尿失禁手术患者60例为对照组,2020年6月至2021年5月收治的压力性尿失禁手术患者79例为观察组。对照组行常规围术期管理,观察组行快速康复外科(ERAS)理念的围术期管理,对比两组留置尿管时间、术后24小时疼痛评分、术后肛门排气时间、术后住院天数、手术时间、术中出血量、术后抗生素使用天数、并发症及总住院费用的差异。结果:观察组术后肛门排气时间、留置尿管时间、术后抗生素使用天数、术后24小时疼痛评分均小于对照组(P<0.05),住院费用、术后住院天数明显少于对照组(P<0.05),观察组术后血栓、恶心、呕吐发生率明显低于对照组(P<0.05)。两组手术时间、术中出血量、术后感染及尿潴留发生率差异无统计学意义(P>0.05)。结论:快速康复外科可加快尿失禁患者术后康复,缩短住院时间,减少住院费用且未增加并发症的风险,推荐临床应用。

Objective:To study the clinical effect of fast track surgery in perioperative period of stress urinary incontinence.Methods:With the method of retrospective study,60 patients with stress urinary incontinence treated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2019 to May 2020 stress were selected as the control group,and 79 patients with stress urinary incontinence treated from June 2020 to May 2021 stress were selected as the observation group.The control group received conventional perioperative management,while the observation group received perioperative management based on ERAS concept.The differences of indwelling catheter time,postoperative 24-hour pain score,postoperative first anusexhaust time,postoperative hospitalization days,operation time,intraoperative blood loss,postoperative antibiotic application days,complications and total hospitalization expenses between the two groups were compared.Results:The postoperative first anus exhaust time,indwelling catheter time,postoperative antibiotic application days and postoperative 24-hour pain score in the observation group were lower than those in the control group(P<0.05),The hospitalization expenses and postoperative hospitalization days were significantly less than those in the control group(P<0.05),The incidence of postoperative thrombosis,nausea and vomiting in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in operation time,intraoperative blood loss,postoperative infection and urinary retention between the two groups(P>0.05).Conclusions:Fast track surgery can accelerate the postoperative rehabilitation of patients with stress urinary incontinence,shorten the hospitalization time,reduce the hospitalization expenses without increasing the risk of complications,so it is recommended for clinical application.