加速康复外科在肾上腺肿瘤微创手术中的应用研究  

Application of enhanced recovery after surgery in minimally invasive surgery for adrenal tumors

作　　者：杨先瑞 康绍叁 郭琪[3] 赵妍[4] 李刚[1] 韩瑞发[1] 蔡启亮[1] YANG Xianrui;KANG Shaosan;GUO Qi;ZHAO Yan;LI Gang;HAN Ruifa;CAI Qiliang(Department of Urology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Urology,North China University of Science and Technology Affiliated Hospital;Department of Imaging,the Second Hospital of Tianjin Medical University;Department of Endocrinology,the Second Hospital of Tianjin Medical University)

机构地区：[1]天津医科大学第二医院泌尿外科,300211 [2]华北理工大学附属医院泌尿外科 [3]天津医科大学第二医院影像科 [4]天津医科大学第二医院内分泌科

出　　处：《天津医药》2024年第10期1038-1040,共3页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(72174144);天津市自然科学基金项目(2021JCYBJC01470);天津市教委基金项目(2022ZD068);天津市科技计划项目(23JCJQJC00080);天津市卫生健康高层次人才培养工程(TJSQNYXXR-D2-158)。

摘　　要：目的探讨加速康复外科(ERAS)应用于肾上腺肿瘤微创手术中的可行性和有效性。方法选择接受后腹腔镜肾上腺肿瘤切除术的患者139例,肿瘤最大径≤6.0 cm。根据围手术期方案分为ERAS组65例和常规组74例。比较2组患者一般资料(年龄、性别、肿瘤位置、肿瘤直径),手术指标(手术时间、手术出血量),术后康复指标(首次下床时间、首次排气时间、术后导尿管留置时间、术后引流管留置时间、术后住院时间)以及并发症的发生情况。结果2组患者性别、年龄、肿瘤位置、肿瘤直径、手术时间和手术出血量比较差异均无统计学意义(P>0.05)。ERAS组患者首次下床时间、首次排气时间、导尿管留置时间、引流管留置时间和住院时间均短于常规组,且术后并发症总发生率低于常规组(P<0.05)。结论ERAS方案应用于肿瘤最大径≤6.0 cm的肾上腺肿瘤患者微创手术中是安全可行的。Objective To evaluate the feasibility and effectiveness of enhanced recovery after surgery(ERAS)in minimally invasive surgery for adrenal tumors.Methods A total of 139 patients underwent retroperitoneal laparoscopic adrenalectomy were selected in this study.The maximum tumor diameter was≤6.0 cm.According to the perioperative plan,patients were divided into the ERAS group(n=65)and the conventional group(n=74).The general information(age,gender,tumor location and tumor diameter),surgical indicators(surgical time and surgical blood loss),postoperative rehabilitation indicators(first off-bed ambulation time,first exhaust time,postoperative catheterization time,postoperative drainage tube retention time and postoperative hospitalization time)and incidence of complications were compared between two groups of patients.Results There were no significant differences in gender,age,tumor location,tumor diameter,surgical time and surgical blood loss between the two groups of patients(P>0.05).In the ERAS group,first off-bed ambulation time,first exhaust time,the indwelling duration of catheters and drainage tubes were shorter than those in the conventional group,and the overall incidence of postoperative complications was lower in the ERAS group than that in the conventional group(P<0.05).Conclusion The ERAS protocol is safe and feasible for minimally invasive surgery in patients with adrenal tumors with a maximum tumor diameter of≤6.0 cm.

关 键 词：术后加速康复 腹腔镜检查 肾上腺肿瘤 围手术期 后腹腔镜 

分 类 号：R699.3[医药卫生—泌尿科学]