加速康复外科在卵巢囊肿剥除术后康复中的应用

解春红 赵恩锋 张宁宁

[摘要] 目的 探索加速康复外科在腹腔镜卵巢囊肿手术患者中的应用价值。 方法 选取2016年1月～2017年12月石家庄市第一医院妇产科诊治的卵巢囊肿患者110例，按收入治疗的次序对患者进行编号，采用随机数字表中三位数随机数，根据秩序大小分为两组，每组各55例。观察组采用引入“加速康复外科”理念的围术期管理方法，对照组采用常规围术期管理方法。记录比较两组术后排气时间、留置尿管时间、下地活动时间、疼痛等级评分、术后住院日和住院费用等术后康复相关指标，以及围术期管理满意度。 结果 与对照组比较，观察组术后排气时间更少、术后留置尿管时间更短、下地活动时间更早、疼痛等级评分更低（P < 0.01）；观察组术后住院日及住院费用均少于对照组（P < 0.01）；观察组围术期管理满意率为92.7%，高于对照组的78.2%（P < 0.05）。 结论 引入“加速康复外科”理念的围术期管理方法能够加速腹腔镜卵巢囊肿手术患者康复进程，改善就医体验，值得普及推广。

[关键词] 卵巢囊肿；腹腔镜；加速康复外科；围术期管理

[中图分类号] R713 [文献标识码] A [文章编号] 1673-7210（2018）08（c）-0099-04

[Abstract] Objective To explore the application of enhanced recovery after surgery （ERAS） in patients with laparoscopic ovarian cysts. Methods A total of 110 patients of ovarian cyst in the First Hospital of Shijiazhuang from January 2016 to December 2017 were selected. According to the order of diagnosis， all cases were numbered corresponding to the number in the random number table， and divided into two groups according to the sequence， with 55 cases in each group. Observation group was given the perioperative management of ERAS and control group was given the routine perioperative management. The postoperative rehabilitation related indicators such as postoperative exhaust time， indwelling catheter， activity time， the pain level score， postoperative hospital stay and the cost of hospitalization of two groups， and the satisfaction rate of perioperative management were recorded and compared. Results Compared with the control group， the postoperative exhaust time and the time of indwelling catheter after operation in the observation group were shorter， the activity time was earlier， and the pain level score was lower （P < 0.01）. The postoperative hospital stay and the cost of hospitalization in the observation group were less than those in the control group （P < 0.01）. The satisfaction rate of perioperative management of the observation group was 92.7%， which was higher than that of the control group （78.2%） （P < 0.05）. Conclusion The methods of ERAS can accelerate the rehabilitation process and improve the medical experience of patients with laparoscopic ovarian cysts， worthy of popularization.

[Key words] Ovarian cysts； Laparoscopy； Enhanced recovery after surgery； Perioperative management

随着腔镜微创技术的发展成熟，腹腔镜卵巢囊肿剥除术作为“标准化”术式已被广泛接受[1]，为进一步改善手术效果，需要向优化围术期管理和缩短术后康复时间等方面努力[2]。加速康复外科（enhanced recovery after surgery，ERAS）是近年来在世界范围广泛应用的术后康复理念，通过借鉴循证医学积累的临床证据，不断改进围术期管理方法，以提高患者术后的康复进程，目前已應用于多个临床学科领域[3]。本研究将加速康复外科理念应用于卵巢囊肿剥除手术患者的术后康复管理中，效果满意，现总结报道如下：