基于加速康复外科理念的全程管理模式在机器人辅助肝切除术患者中的应用效果研究  

Application effect of whole-course management mode based on ERAS concept on patients with robot-assisted liver resection

作　　者：王婷[1] 罗鸿萍 李蓉蓉 张国娇 Wang Ting;Luo Hongping;Li Rongrong;Zhang Guojiao(Hepatic Surgery Center,Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肝脏外科,湖北武汉430030

出　　处：《加速康复外科杂志》2022年第1期19-23,共5页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

基　　金：华中科技大学同济医学院附属同济医院2019年院基金(2019D11)。

摘　　要：目的:探讨基于加速康复外科(enhanced recovery after surgery,ERAS)理念的全程管理模式在机器人辅助肝切除术患者中的应用效果。方法:选取华中科技大学同济医学院附属同济医院收治的121例机器人辅助肝切除术患者作为研究对象,其中2016年6月至2017年6月的58例患者纳入对照组,实施围手术期常规护理;2017年7月至2018年6月的63例患者纳入ERAS组,采取ERAS全程管理模式进行护理干预。比较两组患者术后日常生活自理能力[Barthel指数(Barthel index,BI)]、术后疼痛情况[视觉模拟评分法(visual analogue scale,VAS)]、术后首次肛门排气时间、术后首次排便时间、术后首次下床活动时间、术后首次经口进食时间和术后住院时间。结果:两组患者术前年龄、性别、基础疾病及美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级情况、日常生活自理能力、疼痛情况比较差异均无统计学意义(均P>0.05)。与对照组相比,ERAS组术后日常生活自理能力明显提高,术后疼痛评分明显降低,术后首次肛门排气时间、术后首次排便时间、术后首次下床活动时间、术后首次经口进食时间均明显提前,术后住院时间明显缩短,差异均有统计学意义(均P<0.05)。结论:基于ERAS理念的全程管理模式可加速机器人辅助肝切除术患者的术后康复,提高患者生活质量。Objective:To explore the application effect of whole-course management mode based on enhanced recovery after surgery(ERAS)concept on patients with robot-assisted liver resection.Method:121 patients received robot-assisted liver resection in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Technology enrolled in this study,58 patients admitted from June 2016 to June 2017 were selected as the control group and received routine perioperative nursing,63 patients admitted from July 2017 to June 2018 were enrolled as the ERAS group and received the whole-course ERAS management perioperative nursing.Compare the intervention effects between the two groups.Result:There was no significant difference in preoperative age,gender,underlying diseases,American Society of Anesthesiologists(ASA)classification and self-care ability in daily life between the two groups(all P>0.05).Compared with the control group,the ERAS group obviously improved the postoperative life self-care ability,significantly reduced postoperative pain score,the first anus exhaust time,the first defecation time,first off-bed time and first oral feeding time after surgery were significantly earlier,postoperative hospitalization was significantly shortened,all the difference were statistically significant(all P<0.05).Conclusion:The whole-course management model based on ERAS concept can accelerate postoperative rehabilitation of patients with robot-assisted hepatectomy and improve their quality of life.

关 键 词：加速康复外科 全程管理模式 机器人辅助肝切除 

分 类 号：R619[医药卫生—外科学] R473.6[医药卫生—临床医学]