加速康复外科在妇科腔镜手术中的应用体会

目的:探讨加速康复外科(enhanced recovery after surgery,ERAS)策略用于妇科腔镜手术中的安全性与有效性。方法:将拟行腹腔镜妇科手术的200例患者随机分为ERAS组与对照组。ERAS组围手术期采用ERAS策略处理,对照组采用传统围手术期方案处理。术后2 h、6 h、12 h、24 h采用视觉模拟评分法观察两组患者疼痛程度,对比分析两组术后肛门首次排气时间、术后恶心呕吐发生率、术后住院时间、住院总花费及其他并发症发生情况。结果:与对照组相比,ERAS组术后2 h、6 h、12 h疼痛评分及术后恶心呕吐发生率明显降低(P0.05);术后肛门首次排气时间缩短(P0.05);术后住院时间、住院总费用减少(P0.05)。两组患者术后其他并发症发生率差异无统计学意义。结论:ERAS策略可安全地用于妇科腔镜手术,能有效促进术后恢复、缩短住院时间、降低医疗费用。

Application of enhanced recovery after surgery in gynecological laparoscopic surgery

Objective:To evaluate the safety and efficiency of enhanced recovery after surgery ( ERAS) program used in gyne-cological laparoscopic surgery .Methods:Two hundred patients undergoing gynecologic laparoscopic surgery were randomly divided into two groups:ERAS group and control group .ERAS Group adopted ERAS strategy ,control group adopted conventional therapy strategy . Postoperative pain was measured by visual analogue score at 2 h,6 h,12 h,24 h after surgery.First anal exhaust time,postoperative nausea and vomiting occurrence rate ,postoperative hospital stay ,total hospitalization expenditure and other complications were compara-tively analyzed.Results:Compared with control group ,visual analogue score and nausea and vomiting occurrence rate at 2 h,6 h and 12 h after surgery was significantly reduced (P<0.05);first anal exhaust time,postoperative hospital stay and total expenses of hospitali-zation was less in ERAS group (P<0.05).There was no significant difference in other postoperative complications between the two groups.Conclusions:ERAS strategy can be used for gynecological laparoscopic surgery safely .It can effectively promote postoperative recovery,shorten hospital stay and reduce medical costs .