术后快速康复在小儿腹腔镜围手术期的临床应用与配合  

Clinical application and coordination of ERAS in perioperative period of children laparoscopic surgery

作　　者：崔馨元[1] 崔岩[1] 万宏[1] 

机构地区：[1]哈尔滨医科大学附属第二医院小儿外科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2017年第5期458-460,共3页Journal of Harbin Medical University

摘　　要：目的探讨术后快速康复(enhanced recovery after surgery,ERAS)在小儿腹腔镜围手术期过程中的临床应用及对术后康复的促进和配合。方法回顾性分析2016年1月~2017年5月在哈尔滨医科大学附属第二医院小儿外科行腹腔镜手术的146例患儿,其中76例患儿围手术期施行了ERAS及相关配合(ERAS组),70例患儿实施常规的围手术期配合(对照组)。结果两组治疗效果无明显差异(P>0.05)。ERAS组术后恶心呕吐、躁动的发生率明显低于对照组(P<0.05),但两组之间术后发热的发生率无明显差异(P>0.05)。ERAS组术后进食时间(4.18±0.38)h早于对照组(6.11±0.34)h(P<0.05),术后住院天数(1.05±0.36)天较对照组(1.54±0.94)天明显缩短(P<0.05)。结论基于ERAS理念的围手术期相关配合应用于小儿腹腔镜手术可减轻手术应激,减少术后不良反应的发生,加快术后康复,缩短住院天数,提高患儿家属的满意度。Objective To discuss the clinical application and coordination of ERAS in periop- erative period of children laparoscopic surgery. Methods One hundred and forty-six children who underwent laparoscopic surgery in the Department of Pediatric Surgery of the Second Affiliated Hospital of Harbin Medical University from January 2016 to May 2017 were collected. Children in the ERAS group （n = 76 ） received the coordination based on ERAS during the perioperative period, while those in the control group （n = 70） received traditional routine intervention. Results There was no difference in curative effect between two groups （P 〉 0.05 ）. No postoperative complications occurred in the 146 children. The incidence of dysphoria, nausea and vomiting in the ERAS group was significantly lower than those in the control group （P 〈 0. 05 ）, but the incidence of fever was not different in two groups （ P 〉 0.05 ）. Feeding time of （4. 18± 0. 38）h after surgery in the ERAS group was earlier than that of （6. 11 ± 0. 34） h in the control group （ P 〈0. 05 ）. The length of stay in hospital of （ 1.05 ±0. 36） d in the ERAS group was significantly shorter than that of （ 1.54 ± 0. 94） d in the control group （P 〈 0.05）. Conclusion Intervention based on ERAS during the perioperative period for children laparoscopic surgery can effectively reduce surgical stress and adverse reactions,accelerate children＇ s postoperative rehabilitation, shorten hospital stay, and increase patients＇ satisfaction.

关 键 词：术后快速康复 腹腔镜手术 小儿 配合 

分 类 号：R473.71[医药卫生—护理学]