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Received:October 12, 2022 Published Online:April 20, 2023
Received:October 12, 2022 Published Online:April 20, 2023
中文摘要: 目的 探讨在老年急性阑尾炎患者行腹腔镜下阑尾切除术(LA)围手术期实施ERAS理念的可行性和效果。
方法 回顾性收集2016年1月至2020年10月承德医学院附属医院收治的252例老年急性阑尾炎患者的资料,2016年1月至2017年12月收治并行LA的108例老年患者为传统组,2018年1月至2020年10月收治并行ERAS管理方案下LA的144例老年患者为ERAS组。比较两组术后肛门排气时间、排便时间、首次下床活动时间、首次进普食时间和住院时间,以及术后并发症发生率等。
结果 两组一般资料差异无统计学意义(P>0.05)。ERAS方案显著缩短了术后肛门排气排便、术后首次下床活动、术后首次进食以及住院时间(P<0.01),降低了肺部感染的发生率(P<0.05)。两组患者其他并发症及30d内非计划再手术、再入院发生率差异无统计学意义(P>0.05)。
结论 ERAS方案与传统围手术期处理方案相比具有优势。LA术围术期应用ERAS理念安全、可行,其并发症发生率和再入院率不高于常规方案。
Abstract:Objective To investigate the feasibility and effect of enhanced recovery after surgery(ERAS) protocol in the perioperative period of laparoscopic appendectomy(LA) for the elderly patients with acute appendicitis.
Methods A retrospective analysis was performed on the data of 252 elderly patients with acute appendicitis treated in the Affiliated Hospital of Chengde Medical University from January 2016 to October 2020. There were 108 patients received LA from January 2016 to December 2017 in traditional group(n=108) and 144 cases received LA with ERAS from January 2018 to October 2020 in ERAS group. The postoperative anal exhaust time, defecation time, the first out-of-bed activity time and the first time to eat ordinary food, hospitalization time as well as the incidence of postoperative complications were compared between two groups.
Results There was no significant difference in general data between two groups(P>0.05). The postoperative anal exhaust time, defecation time, the first out-of-bed activity time, the first time of eating ordinary food and hospitalization time were significantly shortened(P<0.01), and the incidence of pulmonary infection reduced in ERAS group compared with those in control group(P <0.05). There was no significant difference in the incidence of other post-operative complications and unplanned reoperation and readmission within 30 days between two groups(P>0.05).
Conclusion ERAS scheme has advantages over traditional perioperative management and is safe and feasible in LA, with the incidence of complications and readmission rate similar to those of conventional treatment.
文章编号: 中图分类号:R656.8 文献标志码:B
基金项目:河北省承德市科学技术研究与发展计划项目(201601A059)
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