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加速康复外科在儿童复杂阑尾炎围手术期的应用研究
引用本文:吴华哲,位永娟,王秋菊,刘家荣. 加速康复外科在儿童复杂阑尾炎围手术期的应用研究[J]. 中国现代医生, 2024, 62(13): 11-14
作者姓名:吴华哲  位永娟  王秋菊  刘家荣
作者单位:泉州市儿童医院小儿外科,福建泉州 362000
基金项目:福建省泉州市科技计划项目(2022NS048)
摘    要:目的 探讨加速康复外科(enhanced recovery after surgery,ERAS)在儿童复杂阑尾炎围手术期的应用效果。方法 选取2020年1月至2023年1月于泉州市儿童医院行腹腔镜手术的复杂阑尾炎患儿248例,根据随机数字表法将其分为对照组和ERAS组,每组各124例。两组患儿均行腹腔镜阑尾切除术,对照组患儿围手术期施行传统治疗方案,ERAS组患儿采用基于ERAS理念的治疗方案。比较两组患儿的术后首次排气/排便时间、住院时间、视觉模拟评分法(visual analogue scale,VAS)评分、术后并发症发生情况及住院满意度。结果 ERAS组患儿的术后首次排气/排便时间、住院时间均明显短于对照组,术后并发症总发生率、术后VAS评分均显著低于对照组,住院满意度显著优于对照组(P<0.05)。结论 儿童复杂阑尾炎围手术期实施ERAS措施,可促进患儿术后早期康复,同时减轻术后疼痛,降低并发症发生率,提高住院满意度,值得临床推广应用。

关 键 词:加速康复外科;阑尾炎;儿童;围手术期管理

Application of enhanced recovery after surgery in perioperative management of complicated appendicitis in children
Abstract:Objective To explore the effect of enhanced recovery after surgery (ERAS) in perioperative period of complicated appendicitis in children. Methods A total of 248 children with complicated appendicitis who underwent laparoscopic surgery in Quanzhou Children’s Hospital from January 2020 to January 2023 were selected and divided into control group and ERAS group according to random number table method, with 124 cases in each group. Both groups of patients underwent laparoscopic appendectomy. The control group received traditional treatment during perioperative period, while the ERAS group received treatment based on the concept of ERAS. The first postoperative exhaust/defecation time, hospital stay, visual analogue scale (VAS) score, postoperative complications and hospitalization satisfaction were compared between two groups. Results The time of first postoperative exhaust/defecation and hospital stay in ERAS group were significantly shorter than those in control group, total incidence of postoperative complications and postoperative VAS score were significantly lower than those in control group, and hospitalization satisfaction was significantly better than that in control group (P<0.05). Conclusion ERAS implementation during perioperative period of complicated appendicitis in children can promote early postoperative recovery, reduce postoperative pain, reduce the incidence of complications, and improve hospitalization satisfaction, which is worthy of clinical promotion and application.
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