加速术后康复理念在腹腔镜袖状胃切除术围术期的应用效果  

Perioperative application of enhanced recovery after surgery in patients undergoing laparoscopic sleeve gastrectomy

作　　者：秦华迪 闵苏[1] 熊秋菊[1] 赵梓作 马婧月 魏珂[1] QIN Huadi;MIN Su;XIONG Qiuju;ZHAO Zizuo;MA Jingyue;WEI Ke(Department of Anesthesiology, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China)

机构地区：[1]重庆医科大学附属第一医院麻醉科,重庆400016

出　　处：《麻醉安全与质控》2019年第2期76-79,共4页Perioperative Safety and Quality Assurance

基　　金：重庆市医学重点学科(07-2);重庆市科技惠民计划集成示范项目(cstc2015jcsf10008)

摘　　要：目的探讨加速术后康复(ERAS)理念应用于腹腔镜袖状胃切除术患者的效果。方法回顾性分析重庆医科大学附属第一医院胃肠外科胃亚专业组2013-06/2018-06期间收治的85例行腹腔镜袖状胃切除术患者的临床资料,根据围手术期是否应用ERAS理念处理分为ERAS组(n=48)及传统组(n=37),比较分析2组围术期效果和并发症情况。结果与传统组相比, ERAS组术前禁饮禁食时间缩短,术毕拔除气管导管、麻醉恢复室(PACU)停留时间、患者腹腔引流管留置、拔除尿管、下床活动、经口进食时间及术后住院时间均缩短,术后疼痛评分、恶心呕吐发生率降低,手术住院费用降低(P<0.05),术后并发症、 1个月内再入院率未增加。结论 ERAS理念应用于腹腔镜下袖状胃切除术能促进患者术后恢复,安全可行。Objective To explore the effect of the enhanced recovery after surgery(ERAS) management in patients undergoing laparoscopic sleeve gastrectomy(LSG). Methods From June2013 to June2018, the clinical data of 85 patients who underwent LSG surgery in the Department of Gastrointestinal Surgery of the First Affiliated Hospital of Chongqing Medical University was analyzed retrospectively.The patients were divided into ERAS group( n =48) and routine group( n =37)according to the different protocol of the perioperative management. The perioperative outcomes and complications were compared in two groups. Results Compared with the routine group, ERAS group had shorter duration of fasting period before operation, significant reduction time of extubation and time of discharge from PACU, significant less retention time of intraperitoneal catheter drainage, patient s early mobilization, early oral feeding, shorter postoperative hospitalization stay, lower pain score and lower incidence of nausea and vomiting, lower hospital cost( P <0.05). In addition, the postoperative complication rate and the readmission rate within1 month had no statistic difference. Conclusion The application of ERAS in LSG surgery, which can promote the recovery of patients after surgery, is a safe and feasible approach.

关 键 词：加速术后康复 腹腔镜下袖状胃切除术 围手术期 

分 类 号：R614[医药卫生—麻醉学]