加速康复外科在腹腔镜胆总管切开取石围术期中的临床应用

Clinical application of enhanced recovery after surgery in perioperative period of laparoscopic common bile duct exploration

目的探讨加速康复外科(ERAS)在腹腔镜胆总管切开取石围手术期中的临床应用。方法选取2015年5月至2018年5月行腹腔镜胆总管切开取石的患者60例,分为ERAS组和对照组,每组30例。ERAS组采用加速康复方案治疗,对照组采用常规治疗,比较2组患者术中有关指标、术后恢复情况、术后并发症及术后疼痛评分。结果2组患者手术时间差异无统计学意义(P>0.05);ERAS组患者术后进食时间、术后排气时间、术后排便时间、下床活动时间、住院时间、住院费用、术后并发症发生率、术后疼痛评分均显著低于对照组(P<0.05),ERAS术后3 d白蛋白(37.25 g/L)高于对照组,差异均有统计学意义(P<0.05)。结论ERAS在腹腔镜胆总管切开取石围手术期中安全有效,可加快患者恢复,有一定的临床价值。

Objective To explore the clinical application of enhanced recovery after surgery(ERAS)in perioperative period of laparoscopic common bile duct exploration(LCBDE).Methods Totally 60 patients underwent LCBDE in our hospital from May 2015 to May 2018 were enrolled and randomly divided into ERAS group(n=30)and control group(n=30).After surgery,enhanced recovery was used in ERAS group,while conventional treatment was used in the control group.The aim was to compare intergroup intraoperative indexes,postoperative recovery,postoperative complications and postoperative pain scores.Results There was no statistical difference in the operation time between the two groups(P>0.05).Postoperative feeding time,postoperative exhaust time,postoperative defecation time,postoperative ambulation time,hospitalization time,hospitalization cost of patients,postoperative complications and postoperative pain scores in ERAS group were significantly lower than those in control group(P<0.05).Albumin(37.25g/L)on postoperative day 3 in ERAS group were significantly higher than that in control group(P<0.05).Conclusion ERAS is safe and effective in perioperative period of LCBDE patients,which can accelerate recovery of patients,with certain clinical value.