基于加速康复外科理念的主动训练方案对腹腔镜肝癌切除术后患者胃肠道功能的影响

The effect of active training program based on the concept of ERAS on gastrointestinal function in patients after laparoscopic hepatectomy

目的:探讨基于加速康复外科(enhanced recovery after surgery,ERAS)理念的主动训练方案对腹腔镜肝癌切除术后患者胃肠道功能的影响。方法:选取2020年8月至2023年3月广州医科大学附属第二医院收治的44例行腹腔镜肝癌切除术患者,按照随机数字表法分为对照组和试验组,各22例。对照组采用常规护理,试验组在常规护理的基础上应用基于ERAS理念的主动训练方案,对比两组患者术后胃肠道功能恢复的相关指标、疼痛评分及术后并发症发生情况。结果:两组患者性别及年龄等一般资料比较差异均无统计学意义(均P>0.05)。试验组患者术后肠蠕动恢复时间、首次排气时间、首次排便时间、首次进食时间及住院时间均短于对照组,术后疼痛程度低于对照组,腹胀发生率低于对照组,以上差异均具有统计学意义(均P<0.05);两组患者出血及胆漏的发生率比较差异均无统计学意义(均P>0.05)。结论:应用基于ERAS理念的主动训练方案,可以加快腹腔镜肝癌切除术后患者胃肠道功能的恢复,促进患者术后康复。

Objective:To investigate the effect of active training program based on the concept of enhanced recovery after surgery(ERAS)on gastrointestinal function in patients with laparoscopic hepatocellular carcinoma resection.Method:44 patients undergoing laparoscopic hepatocellular carcinoma resection from August 2020 to March 2023 in the Second Affiliated Hospital of Guangzhou Medical University were selected and divided into the control group and the experimental group by means of random number table,with 22 cases in each group.The control group received routine nursing while the experimental group received active training program based on ERAS concept on the basis of routine nursing.The relevant indexes of postoperative gastrointestinal function recovery were compared between the two groups.Result:There was no significant difference in gender,age and other general information between the two groups(all P>0.05).The postoperative intestinal peristalsis recovery time,first exhaust time,first defecation time,first eating time and hospital stay of the experimental group were all shorter than those of the control group,all the differences were statistically significant(all P<0.05).In additon,the degree of postoperative pain and the incidence of abdominal distension were both lower than the control group,both of the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of hemorrhage and bile leakage between the two groups(all P>0.05).Conclusion:Active training program based on ERAS concept can accelerate the recovery of gastrointestinal function and promote postoperative rehabilitation of patients after laparoscopic hepatocellular carcinoma resection.