快速康复外科理念在腹腔镜全子宫切除术围手术期的应用效果  

Application effect of the enhanced recovery after surgery in the perioperative period of the laparoscopic total hysterectomy

作　　者：陈玲 钟茜 CHEN Ling;ZHONG Qian(Pingxiang Second People's Hospital,Pingxiang,Jiangxi,337000,China)

机构地区：[1]萍乡市第二人民医院,江西萍乡337000

出　　处：《当代医学》2024年第19期141-144,共4页Contemporary Medicine

摘　　要：目的探究快速康复外科理念(enhanced recovery after surgery,ERAS)在腹腔镜全子宫切除术围手术期的应用效果。方法选取2019年8月至2022年8月于萍乡市第二人民医院行腹腔镜全子宫切除术的90例患者作为研究对象,按照随机数字表法分为两组,各45例。A组给予常规术前准备及宣教,B组在A组基础上基于ERAS实施综合化的围手术期管理。比较两组围手术期指标、并发症发生情况、不同时间点疼痛情况[视觉模拟评分法(visual analogue scale,VAS)评分]及入院时、术后3 d的心理状态[焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)评分]。结果B组肛门排气时间、下床活动时间、住院时间均短于A组,差异有统计学意义(P<0.05);B组术后并发症发生率为6.67%,低于A组的22.22%,差异有统计学意义(P<0.05);术后1、2、3 d,B组VAS评分均低于A组,差异有统计学意义(P<0.05);术后3 d,两组SAS、SDS评分均低于入院时,且B组低于A组,差异有统计学意义(P<0.05)。结论针对实施腹腔镜全子宫切除术患者,围手术期采取基于ERAS实施综合化的围手术期管理,能促进患者术后恢复,降低并发症发生率,减轻术后疼痛及改善负性心理,综合应用效果显著。Objective To explore the application effect of enhanced recovery after surgery(ERAS)in perioperative period of laparoscopic total hysterectomy.Methods A total of 90 patients who underwent laparoscopic total hysterectomy in the Pingxiang Second People's Hospital from August 2019 to August 2022 were selected as the research subjects,and they were divided into the two groups according to random number table method,with 45 cases in each group.The group A received routine preoperative preparation and education,and the group B received integrated perioperative management based on ERAS on the basis of the group A.The perioperative indexes,complications,pain at different time points(visual analogue pain scale[VAS]),and mental state at admission and 3 d after surgery(self-rating anxiety scale[SAS]and self-rating depression scale[SDS]scores)were compared between the two groups.Results The time of anal exhaust,the time of getting out of bed and the time of hospitalization in the group B were shorter than those in the group A,and the differences were statistically significant(P<0.05);the incidence of postoperative complications in the group B was 6.67%,lower than 22.22%in the group A,the difference was statistically significant(P<0.05);on 1,2 and 3 d after operation,VAS scores in the group B were lower than those in the group A,and the differences were statistically significant(P<0.05);at 3 d after operation,SAS and SDS scores of the two groups were lower than those at admission,and the group B was lower than the group A,the differences were statistically significant(P<0.05).Conclusion For patients undergoing laparoscopic total hysterectomy,ERAS integrated perioperative management can promote postoperative recovery,reduce the incidence of complications,alleviate postoperative pain and improve negative psychology,and the comprehensive application efficacy is outstanding.

关 键 词：全子宫切除术 腹腔镜 快速康复外科理念 围手术期 

分 类 号：R473.71[医药卫生—护理学]