加速康复外科在高血压脑出血神经内镜辅助下血肿清除术中的应用效果分析  

Effect of enhanced recovery after surgery in neuroendoscope assisted hematoma clearance of hypertensive cerebral hemorrhage

作　　者：吴灵芝 曾莉[1] 李荣青 张璐 章桂飞[1] 吕彩虹 Wu Lingzhi;Zeng Li;Li Rongqing;Zhang Lu;Zhang Guifei;Lyu Caihong(Department of Neurosurgery,Shanghai Tenth People's Hospital,Shanghai 200072,China)

机构地区：[1]上海市第十人民医院神经外科,上海200072

出　　处：《中国医学前沿杂志（电子版）》2021年第6期63-66,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：上海市第十人民医院国家自然基金院内培育项目(04.03.19.152)。

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在高血压脑出血神经内镜辅助下血肿清除术患者围手术期中的应用效果。方法选择2019年1月至2020年1月于上海市第十人民医院行神经内镜辅助下血肿清除术的76例高血压脑出血患者为研究对象,采用随机数字表法分为观察组与对照组,每组各38例。对照组患者围手术期采用常规干预,观察组患者在围手术期采用ERAS干预,比较两组患者围手术期临床资料,手术前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、Fugl-Meyer量表(Fugl-Meyer assessment,FMA)、改良Barthel指数(modified Barthel index,MBI)评分和患者出院时临床满意度。结果观察组患者的首次排气时间、首次排便时间、住院天数均显著短于对照组(均P<0.05),临床总满意率显著高于对照组(P<0.05)。术后2周,两组患者NIHSS评分均显著低于本组术前水平(均P<0.05),FMA、MBI评分均显著高于本组术前(均P<0.05)。观察组患者术后2周NIHSS评分显著低于同期对照组(P<0.05),FMA、MBI评分均显著高于同期对照组(均P<0.05)。结论ERAS干预在行神经内镜辅助下血肿清除术的高血压脑出血患者围手术期的应用效果满意,有助于加快患者术后神经功能的康复。Objective To investigate the application effect of enhanced recovery after surgery(ERAS)in the perioperative period of neuroendoscope assisted hematoma clearance of hypertensive cerebral hemorrhage.Method From January 2019 to January 2020,76 patients with hypertensive cerebral hemorrhage who were underwent neuroendoscope assisted hematoma clearance in Shanghai Tenth People's Hospital were divided into observation group and control group by random number table method,38 cases in each group.Patients in control group were given routine intervention during perioperative period,while patients in observation group were given ERAS comprehensive intervention during perioperative period.The perioperative clinical data,scores of National Institute of Health stroke scale(NIHSS),Fugl-Meyer assessment(FMA)and modified Barthel index(MBI)before and after operation,and clinical satisfaction at discharge were compared between the two groups.Result In observation group,the first exhaust time,first defecation time and hospitalization days were significantly shorter than those in control group(all P<0.05),and the clinical total satisfaction rate at discharge was significantly higher than that in control group(P<0.05).Two weeks after operation,the scores of NIHSS in two groups were significantly lower than those preoperative levels,and the scores of FMA and MBI in two groups were significantly higher than those preoperative levels(all P<0.05).The scores of NIHSS in observation group was significantly lower than that in control group(P<0.05),the scores of FMA and MBI in observation group were significantly higher than those in control group at the same period(all P<0.05).Conclusion ERAS intervention during perioperative period in neuroendoscope assisted hematoma clearance of hypertensive cerebral hemorrhage is satisfactory,it is helpful to accelerate the recovery of postoperative nerve function.

关 键 词：加速康复外科 高血压 脑出血 神经内镜 血肿清除术 术后康复 

分 类 号：R651.1[医药卫生—外科学]