快速康复外科理念促进腹腔镜根治性膀胱切除术后患者的快速康复

摘要

Objective To investigate the application of enhanced recovery after surgery(ERAS) in laparoscopic radical cystectomy.Methods The clincal data of 62 cases who received laparoscopic radical cystectomy during July 2016 and July2017 were retrospectively analyzed.According to the inclusion and exclusion critcra,the patients were divided;nto ERAS group and conventional management group.The operations of the two groups were performed by the same group of surgeons The operation time,blood loss,the first exhaust time and feeding time after operation,VAS pain score and complication rate were compared between the two groups.Results In the ERAS group and conventional group,the operation time was(297.930± 31.030) vs.(350.340±24.940) min,the first exhaust time was(2.730±0.640) vs.(4.500±0.620) d,the first feeding time was(3.100±0.880) vs.(7.250±0.620) d,the VAS pain score was(5.670±0.880) vs.(8.780±0.940),the QoL score was (21.700± 2.380) vs.(38.060 ± 3.030).There were significant differences between the two groups(P＜0.05).Conclusion The ERAS concept can promote the recovery of patients,shorten the length of hospital stay,reduce postoperative pain and improve the quality of life.%目的 探讨围手术期快速康复外科(ERAS)理念在腹腔镜下根治性膀胱切除术中的应用.方法 回顾性分析贵州省人民医院泌尿外科2016年7月～2017年7月间62例接受腹腔镜下根治性膀胱切除术患者的临床资料,其中根据纳入标准及排除标准不同分为ERAS管理组和常规管理组,两组患者的手术均由同一治疗组医师完成.比较两种治疗方式的手术时间、术中出血量、术后首次排气时间、术后首次进食时间、术后患者主观感觉评分和术后并发症发生率等.结果 ERAS管理组和常规管理组的手术时间分别是(297.930±31.030)min和(350.340±24.940) min,术后首次排气时间分别是(2.730±0.640)d和(4.500±0.620)d,术后首次进食时间分别是(3.100±0.880)d和(7.250±0.620)d,两组间差异均有统计学意义(P＜0.05).术后ERAS管理组和常规管理组患者的VAS疼痛程度评分分别为(5.670±0.880)分和(8.780±0.940)分,QoL舒适度评分分别是(21.700±2.380)分和(38.060±3.030)分,两组间差异均有统计学意义(P＜0.05).结论 ERAS理念能促进腹腔镜下根治性膀胱切除术后患者的恢复,缩短住院时间,减轻术后疼痛,提高生活质量.