加速康复外科理念在肝血管瘤手术中的应用  

Application of Enhanced Recovery after Surgery in Hepatic Hemangioma

作　　者：程亚[1] 荚卫东[1] 

机构地区：[1]安徽医科大学附属省立医院肝脏外科,安徽合肥230001

出　　处：《中国普外基础与临床杂志》2016年第2期147-150,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金资助项目(编号:81172364);安徽省科技攻关资助项目(编号:1301042199)~~

摘　　要：目的探讨加速康复外科理念在肝血管瘤手术中应用的有效性及合理性。方法回顾性分析2011年1月至2015年9月期间我院收治的289例肝血管瘤行手术切除患者的临床资料,按其围手术期处理方法不同分为加速康复外科组(n=146)和传统围手术期处理组(n=143),比较2组患者的术后住院时间、住院费用、术后1、3、5 d胆红素水平、术后并发症发生率、术后24 h和48 h时的疼痛数字评定量表(numerical rating scale,NRS)评分、术后下床活动情况和肠道通气时间、围手术期死亡率、再入院率。结果与传统围手术期处理组相比,加速康复外科组患者的术后出院时间及肠道通气时间明显缩短(P<0.05),住院费用更少(P<0.05),术后并发症发生率更低(P<0.05),术后24 h和48 h时的NRS评分更低(P<0.05),术后第1 d下床活动患者比率更高(P<0.05),而术后1、3、5 d的胆红素水平及再入院率2组间比较差异无统计学意义(P>0.05)。2组均无围手术期死亡患者。结论加速康复外科理念在肝血管瘤手术中的应用是可行及安全的,有利于患者术后的功能恢复,缩短患者术后住院时间及减少住院费用。Objective To explore effectiveness and rationality of using concept of enhanced recovery after surgery in treatment of hepatic hemangioma. Methods The clinical data of 289 patients with hepatic hemangioma underwent hepatectomy were analyzed retrospectively. These patients were divided into enhanced recovery after surgery group（n=146） and traditional perioperative treatment group（n=143） according to the different perioperative treatment methods. The postoperative hospital stay, hospitalization cost, postoperative bilirubin levels on day 1, 3, and 5, postoperative complications rate, postoperative 24 h and 48 h pain numeric rating scale（NRS） score, postoperative ambulation status, intestinal ventilation time, mortality, and readmission rate were compared between these two groups. Results Compared with the traditional perioperative treatment group, the postoperative hospital stay and intestinal ventilation time were shorter（P〈0.05）, hospitalization cost was less（P〈0.05）, postoperative complications rate was lower（P〈0.05）, points of postoperative 24 h and 48 h NRS were lower（P〈0.05）, proportion of postoperative ambulation on day 1 was higher（P〈0.05） in the enhanced recovery after surgery group. While the differences of the postoperative bilirubin levels on day 1, 3, and 5, mortality, and readmission rate were not significantly different between these two groups（P〈0.05）. Conclusion The concept of enhanced recovery after surgery in treatment of hepatic hemangioma is feasible and safe, which is in favor of postoperative functional recovery, and could shorten postoperative hospital stay and reduce hospitalization cost.

关 键 词：加速康复外科 肝血管瘤 

分 类 号：R735.7[医药卫生—肿瘤]