加速康复外科理念在急诊消化道穿孔修补术中的应用  

Application of enhanced recovery after surgery concept in repair of the emergency gastrointestinal perforation

作　　者：黄惠[1] 陈新岐[2] 饶智[1] 潘磊[1] HUANG Hui;CHEN Xin-qi;RAO Zhi(Department of General Surgery, Xinjiang Production and Construction Corps Third Division Hospital, Kashi 844000, Chin)

机构地区：[1]新疆生产建设兵团第三师医院普通外科,844000 [2]东莞市人民医院普通外科,523039

出　　处：《中国实用医药》2018年第16期24-26,共3页China Practical Medicine

基　　金：新疆生产建设兵团第三师科技计划项目(项目编号:YJ2017CX08)

摘　　要：目的探讨加速康复外科(ERAS)理念应用于急诊消化道穿孔修补术的临床效果。方法 47例消化道穿孔患者,根据信封法随机分为观察组(24例)和对照组(23例)。观察组围手术期采用ERAS理念进行管理,对照组围手术期采用传统治疗方法进行管理。观察比较两组患者术后3d C反应蛋白(CRP)水平、疼痛评分、术后肛门首次排气时间、住院时间、住院费用以及术后并发症发生情况。结果观察组CRP水平、视觉模拟评分法(VAS)评分均低于对照组,住院时间、肛门首次排气时间均短于对照组,住院费用少于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为8.33%(2/24),对照组并发症发生率为34.78%(8/23);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 ERAS理念应用于急诊消化道穿孔修补术患者的围手术处理是安全可行的,值得临床推广。Objective To investigate the clinical effect of enhanced recovery after surgery（ERAS） concept in repair of the emergency gastrointestinal perforation. Methods A total of 47 patients with gastrointestinal perforation were divided by envelope method into observation group（24 cases） and control group（23 cases）. The observation group was managed with ERAS concept during perioperative period, and the control group was managed by traditional treatment during perioperative period. Observation and comparison were made on postoperative 3 d C reactive protein（CRP） level, pain score, postoperative anal first exhaust time, hospitalization time, hospitalization expenses and occurrence of postoperative complications between the two groups. Results The observation group had lower CRP and VAS score than the control group, shorter hospitalization time, anal first exhaust time than the control group, and less hospitalization expenses than the control group. Their difference was statistically significant（P〈0.05）. The observation group had incidence of complications as 8.33%（2/24）. The control group had incidence of complications as 34.78%（8/23）. The observation group had lower incidence of complications than the control group, and the difference was statistically significant（P〈0.05）. Conclusion Application of ERAS concept is safe and feasible in repair of the emergency gastrointestinal perforation, and it is worthy of clinical promotion.

关 键 词：加速康复外科 消化道穿孔修补术 围手术期 

分 类 号：R473.6[医药卫生—护理学]