加速康复外科管理模式在腹腔镜卵巢去势术中的应用研究被引量：1

Application of enhanced recovery after surgery management model in laparoscopic ovarian castration

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摘要目的:探讨加速康复外科(ERAS)管理模式在腹腔镜卵巢去势术围手术期的应用效果。方法:选择2019年11月至2023年1月收治的120例需行腹腔镜卵巢去势术的乳腺癌患者,随机分为ERAS组(n=60)与对照组(n=60)。对照组采用常规妇科围手术期处理,ERAS组采用多学科参与的ERAS管理模式。记录并比较两组手术前后焦虑、抑郁状态及手术时间、术后恢复情况(术后首次下床时间、肛门排气时间、7 d内并发症)、总住院时间、诊疗费用、疼痛与恶心呕吐情况。结果:两组术前焦虑自评量表、抑郁自评量表评分差异无统计学意义(P>0.05),ERAS组术后焦虑自评量表、抑郁自评量表评分均低于对照组(P<0.05)。两组手术时间差异无统计学意义(P>0.05)。ERAS组术后首次下床时间、肛门排气时间、总住院时间、诊疗费用低于对照组(P<0.05)。两组咽部不适、感染、血栓形成及胃肠道其他症状等并发症发生率差异无统计学意义(P>0.05)。ERAS组术后3 h、6 h、12 h、24 h疼痛评分及恶心呕吐发生率均低于对照组(P<0.05)。结论:ERAS管理模式可改善腹腔镜卵巢去势术患者的焦虑、抑郁状态,减少术后疼痛、恶心、呕吐等并发症的发生,促进术后恢复,缩短总住院时间,节约诊疗费用。 Objective:To investigate the effect of enhanced recovery after surgery(ERAS)management model in patients undergoing laparoscopic ovarian castration during perioperative period.Methods:A total of 120 patients with breast cancer who required laparoscopic ovarian castration from Nov.2019 to Jan.2023 were selected and randomly divided into ERAS group(n=60)and control group(n=60).The control group was treated with routine gynecological perioperative management,while the ERAS group was treated with multidisciplinary ERAS management model.The preoperative and postoperative anxiety and depression,operative time,postoperative recovery(first time of ambulation after surgery,anal exhaust time,complications within 7 d),total hospital stay,diagnosis and treatment costs,pain,nausea and vomiting were recorded and compared between the two groups.Results:The preoperative self-rating anxiety scale and self-rating depression scale scores were not significantly different between the two groups(P>0.05),the postoperative scores in ERAS group were lower than those in control group(P<0.05).There was no significant difference in operative time between the two groups(P>0.05).The first time of ambulation,anal exhaust time,total hospital stay,diagnosis and treatment costs in ERAS group were significantly lower than those in control group(P<0.05).There were no significant differences in the complications such as pharyngeal discomfort,infection,thrombosis and other gastrointestinal symptoms between the two groups(P>0.05).Pain scores,nausea and vomiting incidences at 3,6,12 and 24 h postoperatively in ERAS group were lower than those in control group(P<0.05).Conclusions:ERAS management mode can improve anxiety and depression in patients undergoing laparoscopic ovarian castration,reduce postoperative complications such as pain,nausea and vomiting,promote postoperative recovery,reduce total hospital stay and save diagnosis and treatment costs.