中国普通外科杂志2017，Vol.26Issue(4)：506-513,8.DOI:10.3978/j.issn.1005-6947.2017.04.017
多学科合作快速康复外科理念在腹腔镜腹股沟疝修补术围手术期的应用
Application of multidisciplinary enhanced recovery after surgery in perioperative period of laparoscopic inguinal hernia repair
欧阳剑波 1黄耿文 1何文 1阳建怡 1魏伟 1纪连栋 1高红梅 2彭淑平3
作者信息
- 1. 中南大学湘雅医院 普通外科,湖南 长沙 410008
- 2. 中南大学湘雅医院 护理部,湖南 长沙 410008
- 3. 中南大学肿瘤研究所,湖南 长沙 410078
- 折叠
摘要
Abstract
Objective: To evaluate the feasibility and effectiveness of using enhanced recovery after surgery (ERAS) protocols based on multidisciplinary team (MDT) cooperation in perioperative period of laparoscopic inguinal hernia repair.Methods: A total of 782 patients scheduled to undergo laparoscopic inguinal hernia repair were randomly assigned to ERAS group (392 cases) and control group (390 cases) according to hospital admission orders. Patients in control group underwent conventional treatment and nursing, while those in ERAS group received treatment and nursing under the concept of MDT-based ERAS, where the main interventions included the selection of hospitalization mode, health education based on integrative medicine and nursing, dietary requirements, bowel preparation, urinary retention prevention, early postoperative ambulation, wound pain treatment, preanesthetic medication, avoidance of perioperative hypothermia, perioperative fluid management, prophylaxis of postoperative nausea and vomiting, and patient comfort assessment at one month after surgery. The scenarios such as postoperative pain, patient recovery, incidence of complications and stress responses, and degree of comfort were compared between the two groups.Results: In the ERAS group compared with control group, the NRS pain score on the morning of postoperative day 1 was decreased, the time to normal diet and ambulation as well as length of hospital stay was shortened, the postoperative satisfaction rate was increased, the incidence of complications such as seroma, urinary retention and wound infection and incidence of discomfort and nausea reaction were reduced, and median score from inguinal pain questionnaire at one month after surgery was decreased (allP<0.05).Conclusion: In perioperative period of laparoscopic inguinal hernia repair, using MDT-based ERAS protocols can alleviate patient discomfort, accelerate rehabilitation, shorten hospital stay, and increase patient satisfaction and comfort.关键词
疝,腹股沟/疝修补术/腹腔镜/围手术期Key words
Hernia/Inguinal/Herniorrhaphy/Laparoscopes/Perioperative Period分类
医药卫生引用本文复制引用
欧阳剑波,黄耿文,何文,阳建怡,魏伟,纪连栋,高红梅,彭淑平..多学科合作快速康复外科理念在腹腔镜腹股沟疝修补术围手术期的应用[J].中国普通外科杂志,2017,26(4):506-513,8.
