ERAS在半尿路切除治疗单侧肾癌中的应用  

Application of ERAS in the treatment of partial resection of urinary tract for unilateral renal carcinoma

作　　者：王涛[1] 宫大鑫[2] 张建勋[1] 高旭[1] 何海宝[1] Wang Tao1, Gong Daxin2, Zhang Jianxun1, et al.(1 Department of Urology, People＇s Hospital of Yanan City, Yanan 716000, China;2 Department of Urology, the First Hospital of China Medical University, Shenyang 110001, China)

机构地区：[1]延安陕西省延安市人民医院泌尿外科,陕西716000 [2]沈阳中国医科大学第一附属医院泌尿外科,辽宁110001

出　　处：《国际泌尿系统杂志》2018年第5期768-770,共3页International Journal of Urology and Nephrology

摘　　要：目的 探讨快速康复外科（enhanced recovery after surgery,ERAS）在半尿路切除术治疗单侧肾癌中的临床效果.方法 选择于2015年3月至2017年9月在本院接受半尿路切除术的单侧肾癌患者80例,根据患者及家属意愿,其中47例采用围手术期ERAS治疗方案（治疗组）,33例采用常规治疗方案（对照组）.观察两组患者术后恢复情况及相应指标变化.结果 治疗组术后进食时间、通气时间、术后住院时间及下床活动时间明显短于对照组（P＜0.05）,同时治疗组患者术后并发症发生率显著低于对照组（P＜0.05）.与治疗后24h相比,两组的TP、HB、Alb、CRP、血糖、胰岛素水平及胰岛抵抗均明显上升（P＜0.05）,而且治疗组显著高于对照组（P＜0.05）.治疗组自围手术期到患者出院平均总费用为2.57万元;对照组平均总费用为3.04万元.结论 ERAS理念护理可降低肾癌患者术后应激反应及术后并发症发生率,改善患者术后营养状况,加速患者术后恢复,减少治疗花费. Objective To explore the clinical effect of enhanced recovery after surgery （ERAS） in treatment of partial resection of urinary tract unilateral renal carcinoma.Methods From March 2015 to September 2017 in our hospital 80 patients with unilateral renal carcinoma were treated by partial resection of urinary.According to the wishes of patients and their families,47 cases were treated with ERAS regimen （treatment group）,33 patients with conventional treatment （control group） in perioperative period.The changes of the corresponding indexes and recovery were observed in two groups.Results After surgery the time of feeding,ventilation,postoperative hospital stay and ambulation time in treatment group were significantly shorter than in control group （P 〈 0.05）,while the incidence of postoperative complications in the treatment group was significantly lower than that in the control group （P 〈 0.05）.Compared with 24 h after treatment,level of TP,HB,Alb,CRP,blood glucose,insulin and insulin resistance in the two groups was significantly increased （P 〈0.05）,and the treatment group was significantly higher than the control group （P 〈 0.05）.The average total cost of the treatment group was 25 700 yuan and the control group was 30 400 yuan,from the perioperative period to the hospital discharge.Conclusions ERAS can reduce the postoperative stress response of patients with renal carcinoma,the incidence of postoperative complications,and the cost of treatment,improve the nutritional status of patients after surgery,and accelerate the postoperative recovery of patient.

关 键 词：肾肿瘤 康复 

分 类 号：R737.11[医药卫生—肿瘤]