腹腔镜外科杂志2017，Vol.22Issue(11)：828-831,4.DOI:10.13499/j.cnki.fqjwkzz.2017.11.828
加速康复外科理念在老年患者腹腔镜胆囊切除围手术期中的应用体会
The application of enhanced recovery after surgery in the perioperative period of elderly patients with laparoscopic cholecystectomy
摘要
Abstract
Objective:To evaluate the clinical value of enhanced recovery after surgery (ERAS) in the perioperative period of elderly patients with laparoscopic cholecystectomy (LC).Methods:The clinical data of 173 elderly patients who underwent LC in Department of Hepatobiliary Surgery,Affiliated Hospital of Binzhou Medical University from Oct.2014 to Nov.2016 were analyzed retrospectively.Patients in the control group received traditional perioperative management,and those in the ERAS group received ERAS intervention.The differences in preoperative fasting time,continuous postoperative electrocardiograph monitoring time,first postoperative ambulation time,first postoperative exhausting time,postoperative opioid drug use rate,postoperative complications incidence,hospital stay,hospitalization expenses,and the readmission rate and mortality within 30 d after discharge between two groups were analyzed.Results:The postoperative first ambulation time in the ERAS group was shorter than that in the control group [(6.99 ± 2.57) h vs.(28.14 ±4.13) h].The first exhaust time in the ERAS group was earlier than that in the control group [(20.34 ± 11.75) h vs.(29.74 ±4.07) h].The postoperative hospitalization time in the ERAS group was shorter than that in the control group [(2.00 ± 1.58) d vs.(5.08 ±2.58) d].The opioid utilization rate in the ERAS group was significantly lower than that in the control group (1/100 vs.5/73),and the hospitalization cost in the ERAS group was lower than that in the control group [(12 700.71 ± 1 680.4) yuan vs.(15 034.09 ± 6 147.0) yuan].All these differences between the two groups were statistically significant (P ＜ 0.05).Conclusions:The application of ERAS in the perioperative period of elderly patients with LC reduces the physical and psychological trauma stress,improves the recovery of gastrointestinal function,significantly shortens the hospital stay,and obviously decreases hospitalization expenses with distinctly clinical effect.关键词
胆囊切除术,腹腔镜/加速康复外科/老年人Key words
Cholecystectomy, laparoscopic/Enhanced recovery after surgery/Aged分类
医药卫生引用本文复制引用
孔令群,张兴元,吕小芹,郭成珑,魏强,杜妍妍,赵宝磊,欧琨,陈强谱..加速康复外科理念在老年患者腹腔镜胆囊切除围手术期中的应用体会[J].腹腔镜外科杂志,2017,22(11):828-831,4.基金项目
山东省自然科学基金资助项目(编号:ZR2014HP028) （编号:ZR2014HP028）
山东省普外科临床重点专科建设项目基金资助(编号:ZDZK2013SJ09) （编号:ZDZK2013SJ09）
