中国普通外科杂志2024，Vol.33Issue(6)：961-969,9.DOI:10.7659/j.issn.1005-6947.2024.06.012
加速康复理念在非介入方式回收下腔静脉滤器患者围术期应用的效果评价
Evaluation of the application of enhanced recovery after surgery principles in perioperative management for patients undergoing non-interventional retrieval of inferior vena cava filters
摘要
Abstract
Background and Aims:The enhanced recovery after surgery(ERAS)concept involves integrating and optimizing perioperative interventions based on evidence-based medical principles and multidisciplinary collaboration.It has been implemented across various surgical fields and has gained widespread recognition.Permanent retention of an inferior vena cava filter(IVCF)can lead to various complications.Guidelines recommend retrieving the filter when the risk of deep vein thrombosis decreases.However,retrieval can be challenging or unsuccessful due to complications such as filter tilt,adherence,perforation,or migration.In such cases,non-interventional surgical methods like laparoscopic or open IVCF retrieval may be employed,though these methods are associated with significant surgical trauma and postoperative complications.There are no reports on the application of ERAS in non-interventional IVCF retrieval.Therefore,this study explores the effectiveness of ERAS-guided perioperative management in patients undergoing non-interventional IVCF retrieval. Methods:The clinical data from 34 patients who underwent non-interventional IVCF retrieval were retrospectively analyzed.Among them,20 patients(from January 2022 to June 2023)received perioperative management based on ERAS principles(observation group),while 14 patients(from July 2020 to December 2021)received traditional perioperative management(control group).Baseline characteristics and intraoperative and postoperative indicators were compared between the two groups. Results:The observation group had a higher average age than the control group(51.2 years vs.39.5 years,P＜0.05).Other factors,including sex,body mass index,preoperative hemoglobin level,medical history,IVCF placement reasons,IVCF location,IVCF type,number of interventional retrieval attempts,IVCF indwelling time,and retrieval methods,showed no significant differences between the groups(all P＞0.05).The observation group had lower intraoperative blood loss,shorter operative time,fewer ICU admissions,shorter nasogastric tube retention time,shorter length of postoperative hospital stays,and lower pain visual analogue scale scores 6 h after operation(all P＜0.05).The overall incidence of complications was lower in the observation group,though the difference was not statistically significant(25.0％vs.50.0％,P＞0.05).Additionally,the observation group had a higher score on the comfort scale(88.5 vs.82.3,P＜0.05)and lower total hospital costs(44 000 yuan vs.54 000 yuan,P＜0.05). Conclusion:The implementation of ERAS management measures in non-interventional IVCF retrieved patients during the perioperative period has a good effect,and the intraoperative measures are safe and effective and have positive effects in promoting patient recovery,alleviating pain,and improving patient treatment experience.关键词
腔静脉滤器/装置取出/术后加速康复/围手术期Key words
Vena Cava Filters/Device Removal/Enhanced Recovery After Surgery/Perioperative Period分类
医药卫生引用本文复制引用
梁陶媛,王萌萌,马琳,王曦竹,鲁雪梅,田轩..加速康复理念在非介入方式回收下腔静脉滤器患者围术期应用的效果评价[J].中国普通外科杂志,2024,33(6):961-969,9.基金项目
首都卫生发展科研专项基金资助项目(首发2022-2-2074) （首发2022-2-2074）
北京市属医院科研培育基金资助项目(PX2022015) （PX2022015）
北京积水潭医院"学科骨干"计划专项基金资助项目(XKGG202213). （XKGG202213）
