中国全科医学2017，Vol.20Issue(24)：2998-3003,6.DOI:10.3969/j.issn.1007-9572.2017.24.012
加速康复外科技术在腹腔镜胆囊切除术患者中的应用价值研究
Study on the Value of Enhanced Recovery after Surgery in Patients with Laparoscopic Cholecystectomy
摘要
Abstract
Objective To observe the effect of enhanced recovery after surgery(ERAS) on negative emotion,nutritional indicators and prognosis of patients with laparoscopic cholecystectomy,in order to provide the theoretical basis for the application of ERAS in patients with laparoscopic cholecystectomy.Methods From May 2014 to May 2016,500 patients accepted laparoscopic cholecystectomy in Department of General Surgery of the Second People′s Hospital of Lanzhou were selected as the study subjects.They were divided into the ERAS group(n=250,using ERAS technique) and the control group(n=250,using conventional method) according to the different measures of perioperative treatment.The negative emotion scores and the nutritional indexes〔prealbumin(PA),albumin(ALB),urea nitrogen(BUN),plasma free amino acid(PFAA)〕 at the time of admission,1 h before operation,24 h after operation and 48 h after operation,and the prognosis indexes 〔postoperative recovery(the recovery time of bowel sounds,exhaust time,defecation time),the incidence of postoperative complications(gallbladder fossa fluid,bile leakage,postoperative bleeding,abdominal infection),hospitalization duration and hospital costs〕 of the two groups were recorded.Results There was interaction in negative emotion scores between treatment method and duration(P<0.05).The main effect of treatment method and duration on negative emotion scores was significant(P<0.05).The negative emotion scores at 1 h before operation,24 h and 48 h after operation in the ERAS group were lower than those in the control group(P<0.05).There was interaction in PA,ALB,BUN and PFAA levels between the treatment method and duration(P<0.05).The main effects of treatment method and duration on PA,ALB,BUN and PFAA levels were significant(P<0.05).The levels of PA,ALB,BUN and PFAA at 24 h and 48 h after operation in the ERAS group were higher than those in the control group(P<0.05).The recovery time of bowel sound,exhaust time and defecation time in the ERAS group were shorter than those in the control group(P<0.05).The hospitalization duration of the ERAS group was shorter than that of the control group,and the hospitalization cost of the ERAS group was less than that of the control group(P<0.05).Conclusion ERAS technique helps to relieve the negative emotions of patients,improve nutritional status and accelerate patient rehabilitation,so as to shorten the length of hospital stay and reduce medical costs.关键词
胆囊切除术,腹腔镜/情绪/营养状况/预后/加速康复外科Key words
Cholecystectomy/laparoscopic/Emotions/Nutritional status/Prognosis/Enhanced recovery after surgery分类
医药卫生引用本文复制引用
芦霞,贾海明,米泰宇,张文权,谢峰,高鹏..加速康复外科技术在腹腔镜胆囊切除术患者中的应用价值研究[J].中国全科医学,2017,20(24):2998-3003,6.基金项目
甘肃省自然科学基金资助项目(145RJZA057) （145RJZA057）
兰州市人才创新创业项目(2015-RC-17) （2015-RC-17）
