加速康复外科在阻塞性睡眠呼吸暂停综合征患者同期多平面手术围手术期的应用价值研究  

Application of accelerated rehabilitation surgery in the perioperative period of simultaneous multi-level surgery in patients with obstructive sleep apnea syndrome

作　　者：卢镇章 陶晶[1] 刘日钊 卢永田[1] 夏荣[1] 王军亮 聂国辉[1] LU Zhenzhang;TAO Jing;LIU Rizhao;LU Yongtian;XIA Rong;WANG Junliang;NIE Guohui(Department of Otolaryngology,Second Hosipital of Shenzhen,Shenzhen,Guangdong,518000,China;Department of Anesthesiology,Second Hosipital of Shenzhen,Shenzhen,Guangdong,518000,China)

机构地区：[1]深圳市第二人民医院耳鼻咽喉科,广东深圳518000 [2]深圳市第二人民医院麻醉科,广东深圳518000

出　　处：《中国耳鼻咽喉头颈外科》2021年第5期305-309,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：2020年深圳市第二人民医院院内临床资助项目(20203357013)。

摘　　要：目的探讨加速康复外科(enhance recovery after surgery,ERAS)理念在阻塞性睡眠呼吸暂停综合征(OSAS)同期多平面手术围手术期的应用价值。方法选取2019年11月2020年7月就诊行两个或两个以上多平面手术的OSAS患者45例,随机分ERAS组(n=22)和对照组(n=23),分别用加速康复干预方案及传统围手术期的处理方式,对比两组患者间的术后静态、吞咽视觉模拟评分量表(VAS)疼痛评分、术后住院天数及住院费用、并发症等结局指标。结果 ERAS组术后12 h及1、2、3、4、5 d的静态VAS评分分别为1.73±1.12、1.59±1.05、1.68±1.13、1.68±1.17、1.41±1.05、1.41±1.05,对照组VAS疼痛评分分别为3.00±1.21、2.78±1.28、2.74±1.05、2.83±0.89、2.30±1.15、2.49±0.73,差异有统计学意义(P均<0.05)。术后ERAS组12 h及1、2、3、4、5 d吞咽疼痛评分分别为3.05±1.21、3.27±1.28、3.09±1.19、2.68±1.29、2.56±1.14、2.46±1.01,对照组12 h及1、2、3、4、5 d VAS疼痛评分分别为5.49±1.93、5.04±1.36、5.00±1.4、4.35±1.07、3.91±1.20、3.70±1.02,差异有统计学意义(P均<0.05),ERAS组患者术后住院天数为(3.50±1.14)d,较对照组(4.49±1.20)d缩短。结论 ERAS应用于OSAS患者围手术期中能降低患者术后疼痛不适,缩短术后住院天数,值得临床推广。OBJECTIVE To explore the application value of the concept of accelerated rehabilitation surgery in the preoperative period of simultaneous multilevel surgery for obstructive sleep apnea syndrome.METHODS Fourty five obstructive sleep apnea syndrome patients were selected for two or more level surgeries from November,2019 to July,2020 and randomly divided into ERAS group(n=22) and control group(n=23).These patients used different preoperative intervention methods.The patient’s outcome indicators included postoperative static,swallowing VAS pain score,postoperative hospital stay,hospitalization expenses,complications were compared between the two groups.RESULTS The static VAS of 12 h,1 d,2 d,3 d,4 d and 5 d in the ERAS group after surgery were 1.73±1.12,1.59±1.05,1.68±1.13,1.68±1.17,1.41±1.05,1.41±1.05,while the VAS of the control group were 3.00±1.21,2.78±1.28,2.74±1.05,2.83±0.89,2.30±1.15,2.49±0.73,the differences were statistically significant (all P values<0.05).Swallowing pain scores of 12 h,1 d,2 d,3 d,4 d and 5 d in the ERAS group after surgery were 3.05±1.21,3.27±1.28,3.09±1.19,2.68±1.29,2.56±1.14 and 2.46±1.01,while the 12 h,1 d,2 d,3 d,4 d,5 d VAS pain scores of the control group were 5.49±1.93,5.04±1.36,5.00±1.45,4.35±1.07,3.91±1.20 and 3.70±1.02,the differences were statistically significant(P<0.05).The number of hospital stays in the ERAS group was(3.50±1.14) days shorter than that of the control group(4.49±1.20),which was statistically different.CONCLUSION The application of ERAS in the preoperative period of OSAS patients can reduce postoperative pain and discomfort and shorten the postoperative hospital stay.It is worth clinical promotion.

关 键 词：加速康复外科 阻塞性睡眠呼吸暂停综合征 多平面手术 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]