改良加速康复外科方案在二级医院腹部微创手术患者围术期的实施与效果评价

目的 探讨个性化的改良加速康复外科（ERAS）方案在二级医院腹部微创手术患者围术期的实施方法与效果。方法 选择在二级医院行腹部微创手术的102例患者,分为观察组51例和对照组49例,对照组患者围术期采用传统的ERAS处理方案,观察组患者围术期采用个性化的改良ERAS处理方案,比较2组患者临床指标及术后并发症发生情况。结果 与对照组相比,观察组术后排气时间较早、术后24 h 疼痛视觉模拟评分较低、住院时间较短（P均< 0.05）。观察组恶心、呕吐、腹胀、肠梗阻及术后低体温等并发症的发生率均低于对照组（P均< 0.05）。结论 在二级医院运用个性化的改良ERAS方案,可减少腹部微创手术患者术后并发症的发生,促进患者早期康复,缩短住院时间。

Perioperative implementation and effect evaluation of enhanced recovery after surgery for patients undergoing minimally invasive abdominal surgery in secondary hospitals

Objective To evaluate the implementation method and effect of enhanced recovery after surgery （ERAS） for patients undergoing minimally invasive abdominal surgery in secondary hospitals. Methods A total of 102 patients undergoing minimally invasive abdominal surgery were divided into the observation group （n = 51） and control group （n = 49）. Patients in the control group were treated with conventional ERAS during the perioperative period, and those in the observation group received modified ERAS. Clinical parameters and the incidence of postoperative complications were statistically compared between two groups. Results Compared with the control group, postoperative exhaust time was significantly earlier, VAS score at postoperative 24 h was remarkably lower and the length of hospital stay was considerably shorter in the observation group （all P < 0.05）. The incidence of vomiting, abdominal distension, intestinal obstruction, postoperative hypothermia and other complications in the observation group was significantly lower than that in the control group （all P < 0.05）. Conclusion Application of modified and individualized ERAS in secondary hospitals can reduce the incidence of postoperative complications, accelerate early recovery and shorten the length of hospital stay of patients treated with minimally invasive abdominal surgery.