加速康复外科在后腹腔镜肾部分切除术中的应用

摘要

目的 探讨加速康复外科(enhanced recovery after surgery,ERAS)在肾癌患者行后腹腔镜肾部分切除术中的临床效果.方法 选取2016年6月至2017年2月本院收治的55例行后腹腔镜肾部分切除术的肾癌患者为研究对象,根据入院先后顺序将入选患者依次纳入试验组(27例)和对照组(28例).试验组患者围术期采用ERAS处理方案,对照组患者围术期采用传统处理方案.分析并比较两组患者术后首次饮水时间、首次下床活动时间、首次肛门排气时间、导尿管留置时间、引流管拔除时间、总住院天数、总住院费用及术后并发症发生情况.结果 两组患者均顺利完成手术,试验组患者术后首次饮水时间、首次下床活动时间、首次肛门排气时间、导尿管留置时间及引流管拔除时间均显著短于对照组(P<0.001),总住院天数和总治疗费用均显著少于对照组(P<0.001).两组患者术后总并发症发生率比较无显著差异(P>0.05).结论 与围术期传统处理方案相比,后腹腔镜肾部分切除术围术期应用ERAS处理方案,可加速患者术后康复,缩短住院天数,减少住院费用,且不增加术后并发症,值得临床推广应用.%Objective To investigate the application value of enhanced recovery after surgery (ERAS) in retroperitoneal laparoscopic partial nephrectomy.Method 55 patients with renal carcinoma treated with laparoscopic partial nephrectomy in our hospital from June 2016 to February 2017 were selected as the objects. They were divided into experimental group (27 cases) and control group (28 cases) according to hospitalization time. Experimental group patients were treated by ERAS, control group patients were treated with conventional therapy during perioperative period. Analyzed and compared the postoperative drinking water for the first time, the first ambulation time, the first anal exhaust time, catheter indwelling time, extubation time and total hospitalization time, hospitalization expenses and postoperative complications between the two groups of patients.Result Two groups of patients were successfully completed surgery, the first time after drinking, the first ambulation time, the first anal exhaust time, catheter indwelling time and extubation time in experimental group were significantly shorter than control group (P<0.001), the total hospitalization time and hospitalization expenses were significantly lower than control group (P<0.001). There wasno significant difference in incidence of postoperative complications between the two groups (P>0.05).Conclusion Comparing to the traditional procedure, the application of ERAS during perioperative period of retroperitoneal laparoscopic partial nephrectomy can effectively accelerate the patients' rehabilitation, reduce hospitalization time and hospi talization expense, while not increasing the overall incidence of postoperative complications.