临床误诊误治2024，Vol.37Issue(7)：43-47,5.DOI:10.3969/j.issn.1002-3429.2024.07.009
基于ERAS理念的心肺功能路径化管理在老年人腹腔镜胆囊切除围术期的应用研究
Application of ERAS Concept-based Cardiopulmonary Function Pathway Management during Perioperative Period of Laparoscopic Cholecystectomy in Elderly Patients
摘要
Abstract
Objective To explore the application effect of cardiopulmonary function pathway management based on the concept of enhanced recovery after surgery(ERAS)during the perioperative period of laparoscopic cholecystectomy in eld-erly patients.Methods A total of 150 elderly patients undergoing laparoscopic cholecystectomy in our hospital from Novem-ber 2019 to November 2022 were selected and divided into observation group(n=75)and control group(n=75)by the ran-dom number table method.The control group was given routine perioperative intervention regimen,while the observation group was given ERAS concept-based cardiopulmonary function pathway management on this basis.The postoperative recovery status(the first time of off-bed activity,the time of first anal exhaust,length of postoperative hospital stay),pain status[Visual An-alogue Scale(VAS)]and activities of daily living[Activities of Daily Living Scale(ADL)],cardiopulmonary function indi-cators[anaerobic threshold(AT),maximum oxygen uptake(VO2 max),peak oxygen pulse(O2 Ppeak),left ventricular ejec-tion fraction(LVEF)]before operation and at 1 d before hospital discharge and complications were compared between groups.Results The first time of off-bed activity,the time of first anal exhaust and the length of postoperative hospital stay in the ob-servation group were shorter than those in the control group(P＜0.01).VAS score of observation group was lower than con-trol group,while ADL score was higher than control group at 1 d before discharge(P＜0.05,P＜0.01).AT,VO2max,O2 Ppeak and LVEF in observation group were higher than those in control group at 1 d before discharge(P＜0.05,P＜0.01).The total incidence of perioperative pulmonary infection,pleural effusion and heart failure in observation group was lower than that in control group(P＜0.05).No serious complications such as biliary fistula and abdominal infection occurred in the two groups.Conclusion ERAS concept-based cardiopulmonary function pathway management can effectively promote the postop-erative rehabilitation of elderly patients undergoing laparoscopic cholecystectomy,improve the cardiopulmonary function and reduce the complications.关键词
快速康复外科/心肺功能/胆囊切除术,腹腔镜/疼痛,手术后/生活质量/最大摄氧量/峰值氧脉搏/左心室射血分数Key words
Enhanced recovery after surgery/Cardiopulmonary function/Cholecystectomy,laparoscopic/Pain,postoperative/Quality of life/Maximum oxygen uptake/Peak oxygen pulse/Left ventricular ejection fraction分类
临床医学引用本文复制引用
马国峰,吴玉..基于ERAS理念的心肺功能路径化管理在老年人腹腔镜胆囊切除围术期的应用研究[J].临床误诊误治,2024,37(7):43-47,5.基金项目
江苏省老年健康科研项目(LKM2022063) （LKM2022063）
