基于加速康复外科理念手汗症日间手术安全性与可行性的回顾性队列研究  

The feasibility and safety of day surgery for palmar hyperhidrosis based on the principles of enhanced recovery after surgery:A retrospective cohort study

作　　者：贺海奇 赵恒 马磊[2] 王哲[1] 温小鹏[1] 张佳[1] 贾卓奇[1] 吴齐飞[1] 张勇[1] 张广健[1] 付军科[1] HE Haiqi;ZHAO Heng;MA Lei;WANG Zhe;WEN Xiaopeng;ZHANG Jia;JIA Zhuoqi;WU Qifei;ZHANG Yong;ZHANG Guangjian;FU Junke(Department of Thoracic Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,P.R.China;Department of Operation,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,P.R.China)

机构地区：[1]西安交通大学第一附属医院胸外科,西安710061 [2]西安交通大学第一附属医院手术部,西安710061

出　　处：《中国胸心血管外科临床杂志》2023年第11期1556-1560,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨加速康复外科理念下胸腔镜交感神经切断术治疗手汗症日间手术模式的安全性和可行性。方法回顾性分析2020年3月—2021年12月西安交通大学第一附属医院手汗症患者的临床资料。根据患者围手术期管理模式将其分为日间手术组和常规手术组。日间手术组患者采用优化的围手术期流程,术中采用喉罩或面罩通气。常规手术组患者按照一般手术流程完成术前检查、手术及术后观察,术中采用单腔气管插管。比较两组患者的一般资料、手术时间、住院时间、并发症、住院费用等。结果最终纳入172例患者,其中男90例、女82例,平均年龄(25.97±7.43)岁。日间手术组86例,常规手术组86例。所有患者术后手汗症状消失。无术中大出血、无中转开胸。两组患者手术时间差异无统计学意义(P=0.534);日间手术组均在24 h内出院,常规手术组平均住院时间(2.09±0.41)d;日间手术组术后呼吸道并发症发生率明显低于常规手术组(P<0.001),住院费用低于常规手术组(P<0.001)。术后两组患者就医满意率均>95%。结论基于加速康复外科理念的手汗症日间手术安全、可行,可减少患者并发症、缩短住院时间、降低住院费用。Objective To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery(ERAS).Methods We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy(ETS)in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021.Patients were divided into a day surgery group and a conventional group according to their perioperative management methods.The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS,and were ventilated with a laryngeal or face mask during the operation.The patients in the conventional group completed the preoperative examination,operation and postoperative observation according to the conventional procedures,and were intubated with a single-lumen endotracheal tube.The demographic characteristics,operation time,hospital stay,postoperative complications,and hospitalization cost were compared between the two groups.Results Finally 172 patients were collected,including 90 males and 82 females,with an average age of 25.97±7.43 years.There were 86 patients in each group.All patients ceased suffering from palmar sweating after surgery.No patient experienced massive bleeding or conversion to thoracotomy.There was no statistical difference in operation time between the two groups(P=0.534).Patients in the day surgery group were discharged within 24 hours.The average hospital stay in the conventional group was 2.09±0.41 days.Incidence of postoperative respiratory complications,and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group(P<0.001).The satisfaction rate in both groups was greater than 95%.Conclusion Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible,which can reduce postoperative complications,shorten the length of hospital stay and save the cost of hospital

关 键 词：手汗症 胸腔镜交感神经切断术 日间手术 加速康复外科 

分 类 号：R473.6[医药卫生—护理学]