快速康复外科理念联合手术路径的改进在腹腔镜下前列腺癌根治术病人围手术期中的应用  

Application of enhanced recovery after surgery combined with the improvement of surgical approach in laparoscopic radical prostatectomy

作　　者：吴荣鑫 章珩 王燕[1] 胡明进 WU Rongxin;ZHANG Heng;WANG Yan;HU Mingjin(Department of Urology,Nanjing Lishui People’s Hospital,Zhongda Hospital Lishui Branch,Southeast University,Nanjing 211200,China)

机构地区：[1]南京市溧水区人民医院(东南大学附属中大医院溧水分院)泌尿外科,江苏省南京市211200

出　　处：《实用老年医学》2024年第6期629-633,共5页Practical Geriatrics

摘　　要：目的探讨快速康复外科理念联合手术入路的改进在腹腔镜下前列腺癌根治术病人围手术期中的应用价值。方法将我院收治的30例行腹腔镜下前列腺癌根治术的病人随机分为对照组(15例)和观察组(15例),对照组接受常规的围手术期处理,手术方式为经腹腔路径腹腔镜下前列腺癌根治术,观察组接受快速康复外科干预模式,手术方式为经腹膜外路径腹腔镜下前列腺癌根治术,比较2组术中、术后情况,以及并发症的差异。结果2组手术时间、术中出血量比较,差异无统计学意义(P>0.05),观察组术后下床活动的时间、VAS评分、肛门排气时间、盆腔引流管及导尿管留置的时间、住院时间及住院费用均低于对照组,差异有统计学意义(P<0.05),观察组呼吸道症状、消化道症状、肠梗阻、泌尿系感染、切口感染的发生率均低于对照组(P<0.05),观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论快速康复外科理念联合手术入路的改进应用于腹腔镜下前列腺癌根治术病人,可减少术后并发症、加速康复进程、节省医疗费用,值得临床应用和推广。Objective To explore the application value of enhanced recovery after surgery(ERAS)combined with the improvement of surgical approach in laparoscopic radical prostatectomy.Methods A total of 30 cases receiving radical prostatectomy were divided into the control group(n=15)and the observation group(n=15).The control group received conventional perioperative treatment,and the surgical method was transperitoneal laparoscopic radical prostatectomy.The observation group received rapid rehabilitation surgical intervention mode,and the surgical method was extraperitoneal laparoscopic radical prostatectomy.The clinical parameters during surgery and after surgery and the complications were compared between the two groups.Results There were no significant differences in operative time and bleeding volume between the two groups(P>0.05).The time of getting out of bed,VAS score,time of anal exhaust,time of indwelling pelvic drainage tube,time of indwelling urinary catheter,hospital stay and medical cost in the observation group were lower than those in the control group(P<0.05).The incidence rates of respiratory symptoms,digestive symptoms,intestinal obstruction,urinary infection and incision infection in the observation group were lower than those in the control group(P<0.05),and the total clinical effective rate of the observation group was higher than that of the control group(P<0.05).Conclusions ERAS combined with the improvement of surgical approach in laparoscopic radical prostatectomy can reduce postoperative complications,speed up the process of rehabilitation and save medical costs,and it is worthy of clinical application and promotion.

关 键 词：快速康复外科理念 手术路径的改进 腹腔镜下前列腺癌根治术 

分 类 号：R697.3[医药卫生—泌尿科学]