加速康复外科在肾移植领域的应用  

Application of enhanced recovery after surgery in renal transplantation

作　　者：柳东夫 于胜强[1] 万峰春[1] 马跃 张成钧 单正飞 王健涛[1] Liu Dongfu;Yu Shengqiang;Wan Fengchun;Ma Yue;Zhang Chengjun;Shan Zhengfei;Wang Jiantao(Department of Organ Transplantation,the Affiliated Yantai Yuhuangding Hospital of Qingdao University,Yantai 264000,China)

机构地区：[1]青岛大学附属烟台毓璜顶医院器官移植科,264000

出　　处：《中华器官移植杂志》2019年第12期734-737,共4页Chinese Journal of Organ Transplantation

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在肾移植术中应用的安全性及有效性。方法选取2016年5月至2018年4月在青岛大学附属烟台毓璜顶医院肾移植受者303例,按随机数字表法分为实验组157例,对照组146例,围手术期分别采用ERAS处理方案和传统处理方案。对两组受者术后首次饮水、进食时间、首次下床活动时间、首次肛门排气时间、导尿管及引流管留置时间、总住院天数、术后肌酐变化、总并发症发生率情况进行比较分析。结果两组受者均顺利完成手术,试验组受者术后首次饮水、进食时间、首次下床活动时间、首次肛门排气时间、导尿管及引流管留置时间均短于对照组,差异有统计学意义(P<0.05),总住院天数少于对照组,差异有统计学意义(P<0.05)。两组受者术后肌酐变化、总并发症发生率差异无统计学意义(P=0.889)。结论与围手术期传统处理方案相比,肾移植围手术期应用ERAS处理方案,可加速受者术后康复,缩短住院天数,且不增加术后并发症的发生风险,建议临床推广应用。Objective To explore the application value of enhanced recovery after surgery(ERAS)during renal transplantation.Methods From May 2016 to April 2018,a total of 303 uremic recipients of renal transplantation were prospectively enrolled.They were randomly divided into experimental group(n=157)and control group(n=146).Experimental group underwent ERAS while control group received conventional therapy during perioperative period.Initial oral intake day,initial ambulation time,initial anal exhaust time,catheter indwelling and exudation time,total hospitalization time,creatinine level and incidence of postoperative complications were compared between two groups.Results All renal transplantations were successfully performed.Initial oral intake day,initial ambulation time,initial anal exhaust time and catheter indwelling and exudation time were significantly shorter than those of control group(P<0.05).Total hospitalization time was significantly lower than control group(P<0.05).No significant inter-group difference existed in creatinine level or incidence of postoperative complications(P=0.889).Conclusions As compared with traditional treatment,application of ERAS can effectively accelerate patient rehabilitation,shorten hospitalization time and increase no incidence of postoperative complications during renal transplantation.

关 键 词：肾移植 加速康复外科 围手术期处理 

分 类 号：R699[医药卫生—泌尿科学]