加速康复外科理念在小儿先天性巨结肠围手术期的应用研究  

Application research of enhanced recovery after surgery in the perioperative period of pediatric Hirschsprung’s disease

作　　者：刘晓铭 杨合英[1] 张翔宇 李炎[1] 任大治 郭志恒 LIU Xiaoming;YANG Heying;ZHANG Xiangyu;LI Yan;REN Dazhi;GUO Zhiheng(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第一附属医院小儿外科,河南郑州450000

出　　处：《中国现代医生》2023年第6期8-11,共4页China Modern Doctor

基　　金：河南省医学科技攻关计划项目(SBGJ202102114)。

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念在小儿先天性巨结肠(hirschsprung’s disease,HD)围手术期中应用的安全性和有效性。方法回顾性分析2017年9月至2021年10月于郑州大学第一附属医院小儿外科接受手术治疗的58例HD患儿的临床资料,将接受传统康复干预措施的27例HD患儿纳入对照组,接受基于ERAS理念干预的31例HD患儿纳入ERAS组,比较两组患者的术后住院时间、术后首次进食时间、完全肠内营养时间,及术后并发症的发生情况。结果ERAS组术后住院时间、术后首次进食时间、完全肠内营养时间均短于对照组,差异有统计学意义(P<0.05)。ERAS组患儿并发症的发生率(3.2%)明显低于对照组(11.1%),差异有统计学意义(P<0.05)。结论围手术期采用ERAS理念可以促进HD患儿术后康复且降低术后相关并发症的发生率。Objective To explore the safety and effectiveness of enhanced recovery after surgery(ERAS)concept in the perioperative period of pediatric Hirschsprung’s disease(HD).Methods The clinical data of 58 children with HD who received surgical treatment in the Department of Pediatric General Surgery of the First Affiliated Hospital of Zhengzhou University from September 2017 to October 2021 were retrospectively analyzed,twenty-seven children with HD who received intervention based on traditional rehabilitation were included in control group,and thirty-one children with HD who received intervention based on ERAS concept were included in ERAS group,the differences in postoperative hospital stay,postoperative first feeding time,postoperative total enteral nutrition time and the incidences of complications between the two groups were compared.The postoperative hospital stay,postoperative first feeding time,postoperative total enteral nutrition time in ERAS group were all shorter than those in control group,and the differences were statistically significant(P<0.05).The incidences of complications in the ERAS group(3.2%)was significantly lower than that of controls group(11.1%),the differences were statistically significant(P<0.05).Conclusion Perioperative ERAS can promote postoperative rehabilitation of children with HD,and reduce the incidences of related complications.

关 键 词：先天性巨结肠 加速康复外科 围手术期管理 

分 类 号：R726[医药卫生—儿科]