加速康复外科联合盆底磁电刺激治疗在老年女性盆腔器官脱垂疾病围手术期的临床研究

Clinical study of enhanced recovery after surgery combined with pelvic floor magnetoelectric stimulation therapy in perioperative period of elderly women with pelvic organ prolapse

目的探讨应用加速康复外科(ERAS)联合盆底磁电刺激治疗优化围手术期管理对老年女性盆腔器官脱垂疾病术后恢复的影响。方法选取2020年6月至2021年5月该院收治的因盆腔器官脱垂行手术治疗的老年女性患者110例作为研究对象,采用随机数字表法分为研究组和对照组,每组55例。研究组围手术期应用ERAS联合盆底磁电刺激治疗,对照组采用常规围手术期管理方案。比较2组患者手术相关指标及术后并发症发生率,以及手术前后40项恢复质量评分量表、盆底功能障碍问卷-20、盆底功能影响问卷简表评分情况等。结果2组患者一般情况、手术时间、术中出血量、麻醉恢复室时间、术后发热情况比较,差异均无统计学意义(P>0.05);研究组患者术后首次下床时间、首次排气时间、首次进食时间、首次排便时间、住院时间均明显优于对照组,术后恶心、呕吐、腹胀、尿潴留、静脉血栓形成发生率,以及术后3个月盆底功能障碍问卷-20、盆底功能影响问卷简表评分均明显低于对照组,术后24、48 h 40项恢复质量评分量表评分均明显高于对照组,差异均有统计学意义(P<0.05)。结论应用ERAS联合盆底磁电刺激治疗可促进老年女性盆腔器官脱垂疾病围手术期的恢复,降低术后并发症发生率,减轻患者不适,提高术后生活质量。

Objective To explore the effect of enhanced recovery after surgery(ERAS)combined with pelvic floor magnetoelectric stimulation therapy to optimize the perioperative management on postoperative recovery of elderly women with pelvic organ prolapse.Methods A total of 110 elderly female patients treated in this hospital from June 2020 to May 2021 were selected as the study subjects and divided into the study group and control group by adopting the random number table method,55 cases in each group.The study group used ERAS combined with pelvic floor magnetoelectric stimulation therapy.The control group adopted the routine perioperative management scheme.The operation-related indexes and the incidence rates of postoperative complications were compared between the two groups,and the scores of Quality of Recovery-40 questionnaire(QoR-40),Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-7(PFIQ-7)before and after operation were compared between the two groups.Results There was no statistically significant difference in the general condition,operation time,intraoperative blood loss volume,time of anesthesia recovery room and postoperative fever between the two groups(P>0.05).The first time to get out of bed,first exhausting time,first eating time,first defecating time and hospitalization time in the study group were superior to those in the control group;the incidence rates of postoperative nausea and vomiting,abdominal distension,urinary retention and venous thrombosis in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The PFDI-20 and PFIQ-7 scores in postopertive 3 months in the study group were significantly lower than those in the control group,the QoR-40 score at postoperative 24,48 h in the study group was significantly higher than that in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion The application of ERAS combined with pelvic floor magnetoelectric stimulation therapy can promote the perioperative recovery of elderly women with pelvic organ prolapse,reduce the incidence rate of postoperative complications,relieve the patients′discomfort and improve the quality of life after operation.