快速康复外科理念在腹腔镜保胆手术中的应用体会

目的 探讨快速康复外科（enhanced recovery after surgery，ERAS）理念应用于腹腔镜保胆手术患者围手术期的临床价值。方法 分析2017年3月至2019年3月90例腹腔镜保胆手术患者的临床资料，其中52例围手术期采用ERAS方案（ERAS组），38例围手术期采用传统方案（对照组）。比较两组患者相关临 床指标。结果 两组患者术前临床资料具有可比性。与对照组比较，ERAS组手术时间、术后第1天WBC正常例数均无统计学差异（P＞0.05），但下床活动时间、肛门排气时间、恢复普通饮食时间、切口疼痛评分3分以上例数、住院时间、住院费用、手术并发症均较对照组明显降低（P＜0.05），而住院满意度明显升高（P＜0.05）。结论 腹腔镜保胆手术患者围手术期应用ERAS理念可以有效地缩短住院时间、降低住院费用、减少手术并发症，从而加快患者的康复。

Application of enhanced recovery after surgery concept in laparoscopic gallbladder preservation surgery

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) concept in perioperative period of laparoscopic gallbladder preservation surgery. Methods The clinical data of 90 patients underwent laparoscopic gallbladder preservation surgery from Mar. 2017 to Mar. 2019 were analyzed. ERAS protocol was used in 52 cases during perioperative period (ERAS group), while 38 cases were treated with the traditional method during perioperative period (the control group). Clinical indicators of the two groups were compared. Results Preoperative clinical data of the two groups were comparable. Compared with the control group, ERAS group showed no statistical difference in operation time or the cases number with normal WBC on the first day after surgery (P>0.05). However, ERAS group had a earlier time of getting out of bed, earlier time of anal exhaust, earlier time of resuming normal diet, and less cases number with incision pain score above 3 points, less hospitalization time, less hospitalization costs, and less surgical complications (P<0.05), and the hospitalization satisfaction was significantly improved (P<0.05). Conclusion The application of ERAS concept in perioperative period of laparoscopic gallbladder preservation surgery can shorten hospitalization time, reduce hospitalization costs and surgical complications effectively, thus contributing to the recovery of patients.