加速康复外科理念在1~3岁日间疝手术中的应用

目的 探讨加速康复外科(ERAS)理念在1~3岁小儿外科日间疝手术中的应用效果。 方法 回顾性分析十堰市某三甲医院小儿外科自2018年7月至2019年9月期间收治的1 100例1~3岁腹股沟斜疝患儿资料,患儿均采用日间模式行腔镜疝手术治疗,按处理措施不同分为ERAS组和标准腔镜组。采用Mann-Whitney U和χ2检验分析两组基本特征分布差异,采用χ2检验和二分类Logistic回归分析比较两组术后指标差异。 结果 ERAS组(550例)和标准腔镜组(550例)在年龄、性别和体质量等方面差异无统计学意义(P>0.05),但ERAS组在饥饿评分、疼痛评分(VAS评分)、Ramsay镇静评分、术后并发症等方面显著优于标准腔镜组(P<0.01)。Logistic回归分析结果显示,标准腹腔镜组的术后并发症发生风险显著高于ERAS组(OR=4.41,95% CI为1.475~13.204)。 结论 ERAS措施在日间模式行腔镜疝手术中比标准腹腔镜治疗更有优势,值得在临床推广应用。

Application of ERAS in day hernia surgery for children aged 1 to 3 years

Objective To explore the application of enhanced recovery after surgery(ERAS)in pediatric day hernia surgery for children aged 1 to 3 years. Methods The clinical data of 1 100 children(1-3 years old)with inguinal hernia treated with day surgery during July. 2018 and Sep. 2019 were retrospectively analyzed. The children were divided into the ERAS group(n=550)and control group(n=550). The difference in the distribution of basic characteristics were compared between the two groups with Mann-Whitney U and Chi-square test. The postoperative indexes were compared with Chi-square test and binary Logistic regression analysis. Results There were no significant differences in age, gender and weight between the two groups(P>0.05). The ERAS group was better in hunger score, VAS score, Ramsay sedation score and postoperative complications than the control group(P<0.01). Logistic regression analysis showed that the control group had significantly higher risk of postoperative complications than the ERAS group(OR=4.41, 95%CI: 1.475-13.204). Conclusion ERAS has more advantages over standardized treatment in day hernia surgery, and it is worth popularizing in clinical practice.