加速康复外科理念在肝硬化门脉高压症围手术期中的应用效果  

The application value of enhanced recovery after surgery in the perioperative period of liver cirrhosis patientswith portal hy-pertension

作　　者：陈欣欣 王继涛 段琼 焦延博 CHENG Xin-xin;WANG Ji-tao;DUAN Qiong(The Xingtai People's Hospital,Xingtai 054001,China)

机构地区：[1]河北医科大学附属邢台市人民医院门脉高压研究中心,邢台054001

出　　处：《肝胆外科杂志》2023年第1期40-44,共5页Journal of Hepatobiliary Surgery

基　　金：河北省重点研发计划项目(18277717D);河北省卫计委科研基金项目(20181612);邢台市重点研发计划项目(2020ZZ026);邢台市科技人才自助计划项目(2019ZZ028);邢台市科技支撑计划项目(2019ZC254)。

摘　　要：目的探讨加速康复外科(ERAS)理念在肝硬化门脉高压症围手术期中的应用效果.方法选取2017年-2019年间我院收治的肝硬化门脉高压症手术患者98例,按照随机数字表的方法将患者随机分为ERAS组(50例)和对照组(48例),ERAS组患者采用ERAS理念行围手术期管理,对照组则按照传统方式行围手术期管理.比较两组患者的相关指标.结果两组患者的一般资料差异无统计学意义(P>0.05),在排气时间、下床时间和住院时间等方面,ERAS组患者的时间(分别为33.8h、31.4h和11.9d)均短于对照组患者(P<0.05),血清前白蛋白和血清白蛋白在术后第5天和术后第8天时ERAS组患者的血清前白蛋白和血清白蛋白明显高于对照组(P<0.05).ERAS组患者的恶心呕吐、腹水发生率明显低于对照组(P<0.05).ERAS组患者术后第3天和第5天的QoR15评分分别为71.6分和126.3分,均高于对照组的62.3分和112.7分(P<0.001).结论肝硬化门脉高压症切除术围手术期应用ERAS理念能缩短术后恢复时间,降低住院日,改善肠道营养,降低术后并发症的发生率,临床推广有较大意义.Objective Discuss the effect of accelerated rehabilitation surgery(ERAS)in perioperative period of hepatocirrho-sis portal hypertension resection.Method The patients with cirrhosis portal hypertension treated in our hospital from 2018 to 2019 were randomly divided into ERAS group(50 cases)and control group(48 cases)according to the method of random number table.The ERAS group was managed perioperatively with the ERAS concept and the control group with the traditional perioperative management.The related indexes of the two groups were compared.Results There was no significant difference in general data between the two groups(P>0.05).The time of ERAS group(33.8 h,31.4h and 11.9 d,respectively)was shorter than that of the control group(P<0.05),serum prealbumin and albumin were significantly higher than those of the control group on the 5th day and 8th day after operation(P<0.05).The incidence of malignant vomiting and ascites in ERAS group was significantly lower than that in the control group(P<0.05).The QoR-15 scores of eras group were 71.6 and 126.3 on day 3 and day 5,All of them were higher than and 112.7 points in the control group(P<0.001).Conclusion Application of perioperative erasERAS concept in hepatocirrhosis portal hypertension resection can shorten postoperative recovery time,reduce hospitalization days,improve intestinal nutrition and reduce the incidence of postoperative complications.

关 键 词：加速康复外科 肝硬化 门静脉高压 围手术期 

分 类 号：R575[医药卫生—消化系统]