加速康复外科在胰十二指肠切除术的临床应用

摘要

目的 探讨胰十二指肠切除术围手术期实施快速康复外科(ERAS)理念的临床应用价值.方法 采用回顾性队列研究方法,收集2012年5月至2016年12月我院56例接受胰十二指肠切除术患者的临床资料.以25例在围手术期实施ERAS的患者为ERAS组,31例接受传统围手术期处理的患者为对照组,对比分析两组术后胰漏、胆漏、出血、术后胃排空障碍、术后肠功能恢复时间、住院时间、住院费用、90天再住院率.结果 ERAS组患者术后胃排空障碍、肠功能恢复时间及住院时间、住院费用均低于非ERAS组,差异均有统计学意义(均P＜0.05).两组患者术后胰漏、胆漏、出血发生率及90天再住院率比较差异均无统计学意义(均P ＞0.05).结论 胰十二指肠切除术患者在围手术期实施ERAS措施,可促进患者早期康复,减少住院时间、费用,安全可行.%Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P ＜ 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P ＞ 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.