加速康复外科理念在腹腔镜下宫颈癌根治术中的管理实践及效果评价

目的:制定适用于腹腔镜下宫颈癌根治术的妇科加速康复外科(Enhanced recovery after surgery,ERAS)方案,评价该方案临床应用效果.方法:组建妇科ERAS多学科团队,筛选最佳实施策略,确立妇科ERAS方案,进行人员培训和方案实施,固化有效措施,并在院内交流实施经验.选择方案实施前146例宫颈癌患者为对照组,实施后128例宫颈癌患者为试验组,比较两组患者术后恢复情况.结果:试验组术后并发症总发生率为21.09％,显著低于对照组(38.36％),差异有统计学意义(P<0.05).两组患者术后住院日、住院费用和术后30d再入院率差异无统计学意义(P>0.05).试验组术后初次下床活动时间、胃肠功能恢复时间均显著低于对照组(P<0.05).结论:将细节落至实处的妇科加速康复外科方案可安全应用于腹腔镜下宫颈癌根治术,缩短患者术后身体功能恢复时间.

Application and effect of enhanced recovery after surgery on laparoscopic radical hysterectomy in patients with cervical cancer

Objective:To develop and evaluate the effect of the gynecological ERAS program on patients with cervical cancer underwent laparoscopic radical hysterectomy(LRH).Methods:An ERAS expert panel was established to develop an optimal strategy for personnel training and solution implementation,the proved experience was promoted to other departments in the hospital.146 patients with cervical cancer were selected into control group and given conventional approaches,128 patients with cervical cancer underwent gynecological ERAS into experimental group.Postoperative recovery indexes between two groups were analyzed and compared.Results:The total incidence of postoperative complications in the experimental group was 21.09%,significantly lower than that in the control group(38.36%),the difference was statistically significant(P<0.05).No significant differences were found on hospital stay,hospital costs and readmission rate 30 days after surgery between the two groups(P>0.05).The time to ambulation,time to recovery of bowel function in the experimental group were significantly shorter than those in the control group(P<0.05).Conclusion:The well-conducted gynecological ERAS program can be safely applied to patients with cervical cancer undergoing LRH,which can effectively shorten the recovery time after surgery.