摘要
目的:探讨加速康复外科(ERAS)在腹腔镜胰十二指肠切除术围手术期管理中的临床应用价值。方法:选取2016年1月至2019年1月收治的168例行腹腔镜胰十二指肠切除术的患者,采用随机数字法分为ERAS组与对照组,ERAS组围手术期采取ERAS措施,对照组采取常规围手术期处理。对比分析两组术后恢复情况、术后并发症发生情况、术后住院时间、住院费用、再次手术率及病死率。结果:ERAS组首次肛门排气时间、进食时间、胃管留置时间、腹腔引流管与尿管拔除时间、疼痛、住院费用、身体质量指数优于对照组,差异均有统计学意义(P<0.05),两组术后总体并发症发生率、胰瘘与腹腔出血情况、再手术、再入院、病死率差异无统计学意义(P>0.05)。结论:腹腔镜胰十二指肠切除术围手术期应用ERAS措施可促进患者术后快速康复,缩短住院时间,降低住院费用,安全性高。
Objective:To explore the clinical value of enhanced recovery after surgery(ERAS)in perioperative management of laparoscopic pancreaticoduodenectomy.Methods:One hundred and sixty-eight patients from Jan.2016 to Jan.2019 were randomly divided into ERAS group and control group.Patients in ERAS group received ERAS measures during perioperative period,while those in control group received routine perioperative treatment.The recovery,complications,hospital stay,hospitalization expenses,reoperation rate and mortality were observed and compared between the two groups.Results:Compared with the control group,the time of first anal exhaust and eating was earlier,the time of gastric tube indwelling was shorter,the time of abdominal drainage tube and urethral catheter removal was earlier,the pain was alleviated in ERAS group,the ERAS group had shorter postoperative hospital stay,lower hospitalization expenses and better body mass index,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative total complications,pancreatic fistula,abdominal hemorrhage,reoperation,readmission or mortality between the two groups(P>0.05).Conclusions:ERAS in perioperative period of laparoscopic pancreaticoduodenectomy can accelerate the recovery,shorten the hospitalization time,reduce the hospitalization cost and improve the safety of patients after laparoscopic pancreaticoduodenectomy.
作者
孙延雷
吕士放
李恩山
SUN Yan-lei;LV Shi-fang;LI En-shan(Department of General Surgery,Linyi Tumor Hospital,Linyi 276000,China)
出处
《腹腔镜外科杂志》
2020年第4期254-258,266,共6页
Journal of Laparoscopic Surgery
基金
临沂市科技发展计划项目(项目编号201818061)。
关键词
胰十二指肠切除术
腹腔镜检查
加速康复外科
围手术期
Pancreaticoduodenectomy
Laparoscopy
Enhanced recovery after surgery
Perioperative period
