加速康复外科集束化管理在肝移植中的应用  

Application of bundle management in enhanced recovery after surgery on liver transplantation-an experience of the large-scale center of transplantation in western China

作　　者：汪守平 张中伟[1] 杨家印[1] 钟西[1] 吴泓[1] Wang Shouping;Zhang Zhongwei;Yang Jiayin;Zhong Xi;Wu Hong.(West China Hospital of Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院,成都610041

出　　处：《中华器官移植杂志》2018年第3期149-153,共5页Chinese Journal of Organ Transplantation

摘　　要：目的探讨加速康复外科（enhancedrecoveryaftersurgery，ERAs）集束化管理在肝移植中的应用效果。方法四川大学华西医院于2016年7月开始正式实施肝移植ERAS集束化管理方案。回顾分析2015年1月至2017年3月间四川大学华西医院收治的220例肝移植受者的临床资料，根据纳入及排除标准，最终入组传统组104例受者，ERAS组92例受者。比较两组术中和术后的临床指标，分析ERAS方案在肝移植中的应用效果。结果ERAS组在手术时间、失血量、重症监护病房（ICU）住院时间、ICU液体量、气管插管时间及住院总时间方面均优于传统组，差异有统计学意义（P〈0．05），且不增加出院1个月再人院率及死亡率。结论肝移植ERAS集束化管理有助于改善肝移植受者的预后。Objective To explore the application of bundle management in enhanced recovery after surgery （ERAS） on liver transplantation. Methods The multidisciplinary team of West China Hospital of Sichuan University discussed the program of ERAS on liver transplantation in 2016, and implemented this program in July 2016. A retrospective analysis was made on 220 liver transplant patients who were admitted to West China Hospital of Sichuan University in the period from Jan. 2015 to Mar. 2017. According to the inclusion and exclusion criteria, there were 104 patients in traditional group and 92 patients in ERAS group. The clinical indicators during and after surgery were compared between the two groups, and the applied value of ERAS on liver transplantation was analyzed. Results As compared with the traditional group, the patients in ERAS group had advantages in operative time, blood loss, postoperative stay in intensive care unit （ICU）, transfusion volume in ICU, endotracheal intubation time and total hospitalization time, with significant difference between the two groups （P〈0. 05）. Meanwhile readmission and mortality rate after one month in ERAS group was not increased. Conclusion The bundle management in ERAS on liver transplantation of West China Hospital of Sichuan University can improve the prognosis of liver transplant patients.

关 键 词：肝移植 生活质量 外科 

分 类 号：R657.3[医药卫生—外科学]