加速康复外科在小儿泌尿外科中的应用:单中心3年经验总结  

Application of enhanced recovery after surgery in pediatric urology:a single-center 3-year experience

作　　者：郭强 钟文文 赖华健 张翼飞 陈冬婷[2] 陈凤玲 叶雷 尧冰 马波[1] 瞿虎[1] 汪中扬[1] 邱剑光 王德娟 GUO Qiang;ZHONG Wenwen;LAI Huajian;ZHANG Yifei;CHEN Dongting;CHEN Fengling;YE Lei;YAO Bing;MA Bo;QU Hu;WANG Zhongyang;QIU Jianguang;WANG Dejuan(Department of Urology,The Sixth Affiliated Hospital,Sun-Yat Sen University,Guangzhou,510655,China;Department of Anesthesia,The Sixth Affiliated Hospital,Sun-Yat Sen University)

机构地区：[1]中山大学附属第六医院泌尿外科,广州510655 [2]中山大学附属第六医院麻醉科

出　　处：《临床泌尿外科杂志》2023年第3期200-205,共6页Journal of Clinical Urology

摘　　要：目的:总结近3年中山大学附属第六医院泌尿外科手术患儿中应用加速康复外科的经验。方法:从医院病案系统收集2018年7月—2021年12月就诊于我科的614例患儿的病例资料,依据纳排标准,最终598例患儿纳入后续研究。收集这些患儿的一般临床资料和ERAS相关资料,包括住院费用、药物费用、手术方式、手术时间、术后住院时间、术后24 h出院率及30 d内再入院率等。结果:患儿的中位就诊年龄为5岁,其中97.8%的患儿在青春发育期前(<12岁)就诊,男547例,女51例,开放手术262例,经泌尿腔道手术94例,腹腔镜手术242例,三、四级手术占比达85.4%。平均住院总费用为(1.52±0.88)万元,平均药物费用为(0.12±0.12)万元,占比约7.9%。平均手术时间为(99±81)min,平均术后住院时间为(1.2±1.5)d,术后24 h出院率达63.4%,而术后30 d内再入院率仅1.7%。结论:加速康复外科非选择性应用于泌尿外科手术患儿的围手术期管理是安全可行的,有助于患儿的术后恢复。Objective:To summarize the experience of applying enhanced recovery after surgery(ERAS)in children undergoing urological surgery in the Sixth Affiliated Hospital of Sun Yat-sen University in the past three years.Methods:The data of 614 children who were treated in our department from July 2018 to December 2021 were collected from the hospital medical record system.According to the inclusion and exclusion criteria,598 children were finally included in the follow-up study.The general clinical data and ERAS-related data of these children were collected,including hospitalization costs,drug costs,surgical methods,operation time,postoperative hospital stay,24-hour discharge rate,and 30-day re-hospitalization rate.Results:The median age of the children was 5 years old,and 97.8%of the children visited the doctor before puberty(<12 years old),including 547 males and 51 females.There were 262 cases of open surgery,94 cases of urinary tract surgery,and 242 cases of laparoscopic surgery.The proportion of third and fourth-grade surgery was 85.4%.The average total hospitalization cost was(15.2±8.8)thousand yuan,and the average drug cost was(1.2±1.2)thousand yuan,accounting for about 7.9%.The average operation time was(99±81)min,the average postoperative hospital stay was(1.2±1.5)d,the discharge rate within 24 h after operation was 63.4%,and the readmission rate within 30 d after operation was only 1.7%.Conclusion:Non-selective application of ERAS in perioperative management of children undergoing urological surgery is safe and feasible,so it’s helpful for postoperative recovery of children.

关 键 词：加速康复外科 小儿泌尿 单中心 经验总结 

分 类 号：R69[医药卫生—泌尿科学]