加速康复外科在腹腔镜手术治疗儿童美克尔憩室中的应用效果研究

Efficacy of enhanced recovery after surgery in laparoscopic treatment for children with Meckel's diverticulum

为探讨加速康复外科(ERAS)应用于腹腔镜手术治疗儿童美克尔憩室的应用效果,回顾性分析2015年1月至2023年1月郑州大学附属儿童医院收治的美克尔憩室患儿的病例资料,将行ERAS联合腹腔镜美克尔憩室手术的69例患儿作为ERAS组,传统围手术期处理方法联合腹腔镜美克尔憩室手术97例患儿为对照组,比较两组患儿的临床及手术相关指标。ERAS组和对照组患儿年龄(t=1.391)、性别(χ^(2)=1.067)、体重(t=1.182)、手术时间(t=1.093)、病变位置(Z=0.405)、手术方式(χ^(2)=0.053)、术中出血量(t=0.394)差异均无统计学意义(均P>0.05)。ERAS组和对照组术后胃管留置时间分别为(1.1±0.7)、(3.8±0.8)d,首次进食时间分别为(2.5±0.6)、(4.9±0.7)d,静脉补液时间分别为(3.9±1.0)、(5.3±1.1)d,住院时间分别为(8.2±1.6)、(10.9±2.3)d,住院费用分别为(1.8±0.2)、(2.1±0.3)万元,ERAS组优于对照组(t=23.289、21.718、8.505、8.379、8.769,均P<0.05)。两组术后并发症发生率比较差异无统计学意义(χ^(2)=0.431,P>0.05)。结果提示ERAS应用于腹腔镜美克尔憩室手术安全有效,有助于患儿术后康复,减少住院花费,缩短住院时间。

Clinical data of 166 children with Meckel's diverticulum,who were treated with laparoscopic surgery in our center from January 2015 to January 2023,were retrospectively analyzed,including 69 cases receiving enhanced recovery after surgery(ERAS group)and 97 cases with traditional perioperative care(control group).There were no significant differences in age(t=1.391),gender(χ^(2)=1.067),body weight(t=1.182),operation time(t=1.093),diverticulum location(Z=0.405),surgical procedures(χ^(2)=0.053),and intraoperative blood loss(t=0.394)between two groups(all P>0.05).Compared to control group,ERAS group had shorter time for indwelling gastric tube(1.1±0.7 d vs.3.8±0.8 d),earlier postoperative feeding(2.5±0.6 d vs.4.9±0.7 d),less intravenous fluid infusion(3.9±1.0 d vs.5.3±1.1 d),shorter length of hospital stay(8.2±1.6 d vs.10.9±2.3 d),and lower hospitalization expenditure(1.8±0.2)×10^(4) yuan vs.(2.1±0.3)×104 yuan(t=23.289,21.718,8.505,8.379,8.769,all P<0.05).There was no significant difference in incidence of postoperative complications between two groups(χ^(2)=0.431,P>0.05).The study indicates that patients treated with ERAS programmed laparoscopic Meckel's diverticulum surgery is safe and effective with rapid recovery and shorter hospital stay.