ERAS策略改善腹腔镜下前列腺癌根治术后疼痛及恢复情况的效果分析  

Effect of enhanced recovery after surgery （ERAS） on postoperative pain and recovery in patients undergoing laparoscopic radical prostatectomy

作　　者：吴云鸿[1] 王蕾[1] 胡雪萍[1] 李丁 

机构地区：[1]无锡市第二人民医院泌尿外科,214000 [2]复旦大学附属华山医院泌尿外科,上海200040

出　　处：《国际医药卫生导报》2017年第20期3154-3157,共4页International Medicine and Health Guidance News

基　　金：上海市卫生和计划生育委员会青年科研项目（2015Y0048）

摘　　要：目的探讨加速康复外科策略（ERAS）对腹腔镜下前列腺癌根治术患者疼痛及术后恢复的影响效果。方法选取2015年1月至2016年12月本院收治行腹腔镜下前列腺癌根治术的患者72例，按数字随机表分为两组，各36例。对照组行常规护理，观察组行ERAS护理，对比两组术后疼痛程度、术后恢复情况和并发症发生率情况。结果观察组术后2、6、12、24h的VAS疼痛评分分别为（1．3±0．2）、（1．2±0．2）、（1．0±0．2）和（0．7±0．1），均低于对照组，差异有统计学意义（P〈0．05）。观察组术后首次排气时间、首次肠鸣音时间、导尿管拔出时间和首次进食时间分别为（43．1±13．7）h、（33．1±12．4）h、（29．1±6．0）h和（26．5±4．2）h，均短于对照组，差异有统计学意义（P〈0．05）。观察组并发症总发生率为5．56％，低于对照组的25．00％，差异有统计学意义（P〈0．05）。结论ERAS应用于腹腔镜下前列腺癌根治术患者效果显著，可有效缓解患者疼痛，促进术后早日恢复，降低并发症发生率，值得推广。Objective To investigate the effect of enhanced recovery after surgery （ERAS） on postoperative pain and recovery in patients undergoing laparoscopic radical prostatectomy. Methods From January 2015 to December 2016, 72 patients who underwent laparoscopic radical prostatectomy were divided into two groups according to the random number table. The control group received routine nursing, while the observation group received ERAS nursing. The postoperative pain, postoperative recovery, and the incidence of complications were compared between the two groups. Results The VAS pain score 2 h, 6 h, 12 h, 24 h after surgery in the observation group were （1.3±0.2）, （1.2±0.2）, （1.0±0.2）, and （0.7±0.1）, lower than those in the control group, with statistically significant differences （P〈0.05）. The postoperative first-time exhaust time, first-time bowel sound time, catheter extubation time, and first-time feeding time in the observation group were （43.1±13.7）h, （33.1±12.4）h, （29. 1±6.0）h, and （26.5±4.2）h, lower than those in the control group, with statistically significant differences （P〈0.05）. The total incidence of complications in the observation group was lower than that in the control group （5.56% vs.25.00%）, with statistically significant difference （P〈0.05）. Conclusion ERAS is effective in patients undergoing laparoscopic radical prostatectomy, which can effectively relieve pain, promote the early recovery, and reduce the incidence of complications, worthy to be popularized.

关 键 词：加速康复外科策略 腹腔镜 前列腺癌 疼痛 术后恢复 

分 类 号：R737.25[医药卫生—肿瘤]