加速康复外科理念指导腹腔镜全子宫切除术对绝经后妇女术后镇痛及胃肠功能恢复的影响

目的:探讨加速康复外科理念指导腹腔镜全子宫切除术对绝经后妇女术后镇痛及胃肠功能恢复的影响。方法:选择2016年1月1日至2020年12月31日南京医科大学附属淮安第一医院收治94例行腹腔镜全子宫切除术的绝经后妇女为研究对象，根据围术期干预方法不同分为对照组（46例）和试验组（48例）。对照组年龄（52.34±7.46）...

Influence of the concept of enhanced recovery after surgery to guide laparoscopic total hysterectomy on post-menopausal women's postoperative analgesia and gastrointestinal function recovery

Objective　To explore the influence of the concept of enhanced recovery aftersurgery (ERAS) to guide laparoscopic total hysterectomy on post-menopausalwomen's postoperative analgesia and gastrointestinal function recovery. Methods　From January 1, 2016 to December 31, 2020, atotal of 94 post-menopausal women who underwent laparoscopic total hysterectomywere selected as the research subjects in Huai'an First Hospital Affiliated toNanjing Medical University. According to different perioperative interventionmethods, they were divided into a control group (46 cases) and an experimentalgroup (48 cases). The control group was (52.34±7.46) years old, and theexperimental group was (52.17±7.32) years old. Both groups of patients weretreated with laparoscopic total hysterectomy. Among them, the patients in thecontrol group received traditional perioperative treatment, and the patients inthe experimental group received perioperative treatment with the concept ofERAS. Relevant rehabilitation indicators, postoperative gastrointestinalfunction recovery, Visual Analogue Scale (VAS) scores at different time pointsafter surgery, and complications were compared between the two groups.Independent sample t test was usedfor comparison of the measurement data between groups, paired t test was used for comparison of themeasurement data within groups, and χ² test was used for the countdata. Results　There were nostatistically significant differences in the intraoperative blood loss andoperation time between the two groups (both P>0.05),and the postoperative hospital stay in the experimental group was shorter thanthat in the control group [(4.38±0.62)d vs. (6.97±1.04)d] (P<0.05). In the experimental group, the first postoperative analexhaust time, the first postoperative defecation time, and the firstpostoperative feeding time were (21.61±4.28) h, (60.35±6.14) h, and (1.34±0.36)d, respectively, which were shorter than those in the control group[(25.49±5.56) h, (64.28±7.32) h, and (3.58±0.67) d], with statisticallysignificant differences (all P<0.05).The VAS score 48 h after surgery was lower than that 6 h after surgery in bothgroups, and the VAS scores in the experimental group 6 h and 48 h after surgerywere (3.21±0.46) points and (1.17±0.22) points, respectively, lower than thosein the control group [(5.56±0.74) points and (3.24±0.43) points], withstatistically significant differences (all P<0.05).There was no statistically significant difference in the total complicationrate between the two groups within 7 days after surgery (P>0.05). Conclusion　The concept of ERASto guide laparoscopic total hysterectomy can promote the recovery ofgastrointestinal function in postmenopausal women, reduce postoperative pain,and is safe and reliable.