ERAS在经脐单孔腹腔镜胆囊切除术治疗胆囊良性疾病中的应用  

Application of enhanced recovery after surgery in the treatment of gallbladder benign diseases with transumbilical single hole laparoscopic cholecystectomy

作　　者：严富国[1] 王方平[1] 石余[1] 丁杭良 俞丽君[1] 雷正东[1] Yan Fuguo;Wang Fangping;Shi Yu(The People's Hospital of Xinchang County,Xinchang,Zhejiang312500)

机构地区：[1]新昌县人民医院,浙江新昌312500

出　　处：《基层医学论坛》2020年第29期4156-4158,共3页The Medical Forum

摘　　要：目的探讨加速康复外科(ERAS)技术在经脐单孔腹腔镜胆囊切除术(TSHLC)治疗胆囊良性疾病中的应用价值。方法选取2017年6月—2019年10月择期行TSHLC治疗的320例胆囊良性疾病患者,随机分为ERAS组和对照组,每组160例。ERAS组运用ERAS技术,对照组采用传统的围手术期处理,观察2组C反应蛋白(CRP)和白细胞(WBC)计数水平、负性情绪得分、术后第1天切口数字疼痛评分(NRS)、住院时间及医疗费用、术后并发症发生率。结果ERAS组术后第1天CRP和WBC计数较对照组均明显降低(P<0.05)。ERAS组术前2 h、术后第1天、术后第2天负性情绪得分较对照组均明显降低(P<0.05)。ERAS组术后第1天切口NRS评分较对照组明显降低(P<0.05)。与对照组相比,ERAS组患者的住院时间明显缩短,医疗费用显著降低(P<0.05)。2组切口感染、腹腔出血、尿潴留等并发症发生率无显著差异(P>0.05)。结论ERAS技术应用在TSHLC治疗胆囊良性疾病中是安全有效的,可减轻患者的应激反应和术后疼痛,加快术后康复,缩短住院时间,降低医疗费用。Objective To study the application value of enhanced recovery after surgery(ERAS)technique in the treatment of gallbladder benign diseases by transumbilical single hole laparoscopic cholecystectomy(TSHLC).Methods A total of 320 patients with gallbladder benign disease who were selected to receive TSHLC treatment from June 2017 to October 2019 were randomly divided into ERAS group and control group,with 160 patients in each group.ERAS group adopted ERAS technology,while the control group adopted traditional perioperative treatment technology.The levels of C-reactive protein(CRP)and white blood cell(WBC)counts,negative emotion scores,numerical rating scale(NRS)for incision on the first postoperative day,hospital stay and medical expenses,and the incidence of postoperative complications were observed.Results The CRP and WBC count levels:on the preoperative one day:there was no significant difference between the two groups(P>0.05);on the postoperative the first day:two indexes in ERAS group were significantly lower than those of the control group(P<0.05).The ERAS group's negative emotion scores were significantly lower than those of the control group on the preoperative the second hour,postoperative the first and second day(P<0.05).The NRS for incision of ERAS group on the first day after surgery was significantly lower than that of the control group(P<0.05).Conclusions ERAS technology is safe and effective in the treatment of gallbladder benign diseases with TSHLC,which can reduce the stress response of patients and postoperative pain,accelerate the postoperative recovery of patients,shorten the length of hospital stays,and reduce medical costs.

关 键 词：胆囊良性疾病 经脐单孔腹腔镜胆囊切除术 加速康复外科 应用价值 

分 类 号：R657.4[医药卫生—外科学]