改良加速康复外科在腹腔镜肾部分切除术中的应用  

Application of improved enhanced recovery after surgery in laparoscopic partial nephrectomy

作　　者：董德鑫[1] 张玉石[1] 严维刚[1] 石冰冰[1] DONG Dexin;ZHANG Yushi;YAN Weigang;SHI Bingbing(Department of Urology,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院泌尿外科,北京100730

出　　处：《基础医学与临床》2023年第11期1702-1706,共5页Basic and Clinical Medicine

摘　　要：目的探讨改良加速康复外科(ERAS)在腹腔镜肾部分切除术中的可行性和安全性。方法回顾性分析2019年5月至2021年6月北京协和医院泌尿外科采用腹腔镜肾部分切除术治疗的肾肿瘤患者临床资料,根据围术期是否采用改良加速康复外科策略分为常规组和改良ERAS组,比较两组患者的术后恢复情况和并发症发生情况。结果共纳入243例患者,其中改良ERAS组142例,常规组101例,两组患者所在地域、年龄、性别和肿瘤分期等基线指标差异无统计学意义。改良ERAS组患者术后首次饮水时间、首次排气时间、首次下床活动时间、导尿管拔除时间、引流管拔除时间、术后住院天数等均早/短于常规组,住院总花费、住院期间术后总并发症发生率均低于常规组(P<0.05)。结论腹腔镜肾部分切除术围术期应用改良ERAS有助于加速患者术后康复,相比常规手术更加安全有效,值得临床推广。Objective To investigate the feasibility and safety of modified enhanced recovery after surgery(ERAS)in laparoscopic partial nephrectomy.Methods A retrospective analysis was conducted with the clinical data of renal tumor patients treated with laparoscopic partial nephrectomy in the Urology Department of Peking Union Medical College Hospital from May 2019 to June 2021.According to the peri-operative ERAS strategy,they were divided into modified ERAS group and conventional group.The postoperative recovery and complications of the two groups were compared.Results A total of 243 patients were enrolled,including 142 in the modified ERAS group and 101 in the conventional group.There was no significant difference between the two groups in baseline of indicators such as region,age,gender and tumor stage.The time records of first drinking water,the time of first exhaust,the first off-bed movement,catheter removal and drainage tube removal,the post-operative hospital stay and the total expense of hospitalization in the improved ERAS group were significantly superior to those in the conventional group(all P<0.05).Conclusions The application of improved ERAS during the peri-operative period of laparoscopic partial nephrectomy may accelerate post-operative recovery.

关 键 词：肾肿瘤 腹腔镜肾部分切除术 加速康复外科 围术期 

分 类 号：R699.2[医药卫生—泌尿科学]