摘要
目的探讨加速康复外科理念在老年患者腹腔镜经腹腹膜前腹股沟疝修补术中的应用。方法选择2018年10月—2019年3月本院普通外科收治的140例老年腹股沟疝患者作为研究对象,按入院顺序分为加速康复外科(ERAS)模式组和传统模式组,每组各70例。ERAS模式组患者围手术期采用ERAS标准处理流程,传统模式组采用传统处理流程。比较两组术后第1天视觉模拟评分(VAS)、术后首次排便时间、首次离床活动时间、正常进食时间及术后住院天数;比较两组出现尿潴留、血清肿、切口感染、术后慢性疼痛等不良反应情况。结果 ERAS模式组在术后第1天VAS评分小于传统模式组,在术后首次排便时间、首次离床活动时间、正常进食时间、术后住院天数均短于传统模式组,差异有统计学意义(P<0.05);传统模式组在尿潴留、血清肿的发生率上高于ERAS组,差异有统计学意义(P<0.05),两组在切口感染、术后慢性疼痛发生率上差异无统计学意义,(P>0.05)。结论 ERAS模式可以明显缩短老年患者经腹腹腔镜下腹股沟疝修补术后首次排便时间、首次离床活动时间、正常进食时间、术后住院天数,减轻患者术后疼痛,减少了尿潴留及血清肿的发生率,并不增加切口感染及术口慢性疼痛的机会,值得在临床上推广应用。
Objective To explore the application effect of the concept of enhanced recovery after surgery in laparoscopic transperitoneal inguinal hernia repair in elderly patients.Methods 140 elderly patients with inguinal hernia those who were hospitalized in our hospital from October 2018 to March 2019 were selected as the research subjects.They were divided into the enhanced recovery after surgery(ERAS)model group and the traditional model group according to the admission order,with 70 patients in each group.Patients in the ERAS model group adopted the ERAS standard procedure during the perioperative period,and the traditional model group adopted the traditional procedure.The visual analogue score(VAS)on the first day after operation,the time of the first postoperative defecation,the time of the first out of bed,the time of normal eating,and the days of hospital stays were compared between the two groups.Adverse reactions such as urinary retention,seroma,incision infection,and postoperative chronic pain were compared between the two groups.Results VAS score in the ERAS model group was less than that of the traditional model group on the first day after surgery.The time of first defecation,the time of the first out of bed,the time of normal meals,and the number of hospital stays after surgery were shorter than those of the traditional model group.The differences were statistically significant(P<0.05).The incidence of urinary retention and seroma was higher in the traditional model group than in the ERAS group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of incision infection and postoperative chronic pain between the two groups(P>0.05).Conclusions The ERAS model could significantly shorten the first defecation time,the time first out of bed,the normal eating time,and the length of postoperative hospital stay in elderly patients after laparoscopic inguinal hernia repair.Incidence rate of urinary retention and seroma decreased,and the chance of incision infection and chronic pain in the surgical incision does not increase,which is worthy of clinical application.
作者
向广阳
陈勇平
欧昌柏
XIANG Guang-yang(Department of general surgery,people's hospital of Huidong County,Huizhou,Guangdong,516300,China.)
出处
《齐齐哈尔医学院学报》
2020年第11期1338-1341,共4页
Journal of Qiqihar Medical University
关键词
腹股沟疝
加速康复外科
老年患者
腹腔镜经腹腹膜前腹股沟疝修补术
inguinal hernia
Enhanced recovery after surgery
Elderly patients
Laparoscopic transperitoneal inguinal hernia repair
