ERAS理念在儿童日间急性单纯性阑尾炎围手术期的应用

目的 探讨加速康复外科（enhanced recovery after surgery，ERAS）理念在儿童日间急性单纯性阑尾炎围手术期的应用效果。方法 回顾性分析十堰市太和医院小儿外科自2019年6月至2021年9月收治的120例急性单纯性阑尾炎患儿资料，患儿均采用日间模式行腹腔镜阑尾切除术治疗，采用数字表法随机分为ERAS组和对照组，每组各60例，比较两组患儿的一般资料和手术时间、术中出血量、饥饿评分、疼痛评分、住院时间、术后首次排便时间、并发症及满意度。结果 两组患儿的年龄、性别、体重、术前白细胞（leukocyte，white blood cell，WBC）及手术时间、术中出血量比较，差异均无统计学意义（P>0.05）。两组患儿的住院时间、术后首次排便时间明显短于对照组（P<0.001）。两组患儿的饥饿评分、疼痛评分、并发症及满意度与对照组比较，差异均有统计学意义（P<0.05）。结论 通过优化传统围手术期流程，将ERAS理念应用于儿童日间急性单纯性阑尾术的术前、术中及术后，ERAS路径在围手术期的住院时间、术后首次排便时间、饥饿评分、疼痛评分、并发症及满意度方面更优，安全可行，效果确切且保障了儿童日间急性单纯性阑尾术安全可行性。

Application of ERAS concept in perioperative period of children with daytime acute simple appendicitis*

Objective To explore the effect of enhanced recovery after surgery (ERAS) concept in the perioperative period of acute simple appendicitis in children. Methods A total of 120 children with acute simple appendicitis admitted to the pediatric surgery department of Taihe Hospital of Shiyan City from June 2019 to September 2021 were retrospectively analyzed. All children were treated with endoscopic appendectomy in daytime mode. According to different treatment measures, they were divided into ERAS group (study group) and control group, with 60 cases in each group. The general information, operation time, intraoperative bleeding, hunger score, pain score, hospital stay, first postoperative defecation time, complications and satisfaction of the two groups were compared. Results There was no significant difference in the age, sex, weight, preoperative leukocyte, white blood cell (WBC), operation time and intraoperative bleeding between the two groups (P>0.05). The hospitalization time and the first postoperative defecation time of the two groups were significantly shorter than those of the control group (P<0.001). There were significant differences in hunger score, pain score, complications and satisfaction between the two groups and the control group (P<0.05). Conclusion By optimizing the traditional perioperative process, this study applies the ERAS concept to the preoperative, intraoperative and postoperative of children''s daytime acute simple appendectomy. The ERAS path is better in perioperative hospital stay, postoperative first defecation time, hunger score, pain score, complications and satisfaction, safe, feasible and effective. In addition, it ensures the safety and feasibility of daytime acute simple appendectomy in children.