加速康复外科在鼻中隔偏曲矫正术围手术期的应用效果

目的 探讨在鼻内镜下鼻中隔偏曲矫正术围手术期实施加速康复外科(ERAS)理念的效果。 方法 前瞻性选取中山市人民医院行鼻内镜下鼻中隔偏曲矫正术的40例患者纳入研究。随机分为常规组和ERAS组,每组20例。常规组给予常规围手术期处理措施,ERAS组给予ERAS方案。比较两组术后鼻部疼痛视觉模拟评分(VAS)、术后住院时间、术后恢复质量-15(QoR-15)评分及术后并发症。 结果 ERAS组术后24 h、48 h鼻部疼痛VAS评分分别为2(1,3)分和1(1,1.75)分,均低于常规组5(4.25,6.75)分和3(2.25,4)分(均P<0.001)。ERAS组术后住院时间为2(2,2)d,比常规组为4(4,5)d缩短,差异具有统计学意义(Z=-5.400,P<0.001)。术前ERAS组和常规组QoR-15评分分别为(141.6±3.5)分和(141.9±3.7)分,差异无统计学意义(t=-0.308,P=0.760)。术后24 h、48 h ERAS组QoR-15评分为(138.8±3.8)分和(141.8±2.9)分,均高于常规组(103.5±8.5)分和(126.2±8.6)分,差异具有统计学意义(t=16.841,P<0.001;t=7.689,P<0.001)。两组并发症发生率差异无统计学意义(χ2=0.360,P=0.548)。 结论 ERAS方案用于鼻中隔偏曲围手术期安全有效,可缩短住院时间,提高生活质量。

Effect of enhanced recovery after surgery in the perioperative period of endoscopic septoplasty

Objective To investigate the effect of enhanced recovery after surgery(ERAS)in the perioperative period of endoscopic septoplasty.Methods Forty patients undergoing endoscopic septoplasty from July 2017 to October 2019 were prospectively selected for the study,and were randomly divided into the routine group(20 patients)and ERAS group(20 patients).The routine group was given routine perioperative treatment measures,while the ERAS group was given the ERAS program.The visual analog score(VAS)for postoperative nasal pain,postoperative hospital stay,postoperative recovery quality-15(QoR-15),and postoperative complications were compared between the two groups.Results The VAS scores 24 and 48 hours after the operation in the ERAS group were 2(1,3)and 1(1,1.75),respectively.These were lower than those in the routine group 5(4.25,6.75)and 3(2.25,4),respectively;P<0.001.The postoperative hospitalization time in the ERAS group was 2(2,2)days,which was shorter than that in the routine group 4(4,5)days.This difference was statistically significant(Z=-5.400,P<0.001).The preoperative ERAS group and routine group QoR-15 scores were 141.6±3.5 and 141.9±3.7,respectively,which was not statistically significant(t=-0.308,P=0.760).The QOR-15 scores of the ERAS group,24(138.8±3.8)and 48(141.8±2.9)hours after the operation were higher than those of the routine group(103.5±8.5 and 126.2±8.6,respectively).This difference was statistically significant(t=16.841,P<0.001;t=7.689,P<0.001).There was no significant difference in the incidence of postoperative complications between the two groups(χ²=0.360,P=0.548).Conclusion ERAS is safe and effective in the perioperative period of endoscopic septoplasty,it can shorten hospitalization time and improve quality of life.