[1]李滢旭 方登华 杨浩雷 刘天锡 皇甫秀春.加速康复外科在腹腔镜减肥手术中的初步应用体会[J].中华肥胖与代谢病电子杂志,2016,2(01):30-34.[doi:10.3877//cma.j.issn.2095-9605.2016.01.007]
 Li Yingxu,Fang Denghua,Yang Haolei,et al.Preliminary application experience of enhanced recovery after laparoscopic bariatric surgery[J].Chinese Journal of Obesity and Metabolic Disease (Electronic Edition),2016,2(01):30-34.[doi:10.3877//cma.j.issn.2095-9605.2016.01.007]
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加速康复外科在腹腔镜减肥手术中的初步应用体会()
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《中华肥胖与代谢病电子杂志》[ISSN:2095-9605/CN:11-9362]

卷:
第2卷
期数:
2016年01期
页码:
30-34
栏目:
临床研究
出版日期:
2016-03-30

文章信息/Info

Title:
Preliminary application experience of enhanced recovery after laparoscopic bariatric surgery
作者:
李滢旭 方登华 杨浩雷 刘天锡 皇甫秀春
655000 云南曲靖,曲靖市第二人民医院肝胆外科
Author(s):
Li YingxuFang Denghua Yang Haolei Liu Tianxi Huang-Fu Xiuchun.
Department of Hepatobiliary Surgery, theSecond People’s Hospital of Qujing, Qujing 655000, ChinaCorresponding author: Fang Denghua, Email:31765270@qq.com
关键词:
加速康复外科 腹腔镜减肥手术 应用价值
Keywords:
Enhanced recovery after surgery Laparoscopic bariatric surgery Application value
DOI:
10.3877//cma.j.issn.2095-9605.2016.01.007
摘要:
目的 初步探讨加速康复外科(enhanced recovery after surgery,ERAS)在腹腔镜减肥手术中的应用价值。方法 回顾性分析2013年2月至2015年9月在曲靖市第二人民医院肝胆外科接受腹腔镜减肥手术治疗的25例患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。根据围手术期是否实施ERAS策略,将患者分为ERAS组(研究组)和非ERAS组(对照组)。其中研究组14例,男5例,女9例;平均年龄(31±8)岁。对照组11例,男4例,女7例;平均年龄(33±9)岁。ERAS策略主要包括术前低脂饮食、预防性使用抗生素;术中增加硬膜外阻滞麻醉、低潮气量通气;术后早期进食和下床运动等。比较两组患者术后并发症发生率、肛门排气时间、术后住院天数、总住院费用等指标。两组资料的比较采用t检验和Fisher确切概率法。结果 所有患者均顺利完成手术,无严重并发症发生。研究组术后恶心/呕吐4例,明显少于对照组的7例(P<0.05)。研究组术后肛门排气时间为(2.6±0.6) d,明显短于对照组的(3.4±0.9) d(t=–2.313,P<0.05)。研究组术后住院天数为(7.2±1.1) d,明显短于对照组的(8.2±0.6) d(t=–2.715, P<0.05)。研究组总住院费用为(4.6±0.3)万元,明显低于对照组的(4.9±0.3)万元(t=–2.203,P<0.05)。结论 ERAS理念应用于腹腔镜减肥手术是安全可行的,需进一步制定一套符合我国肥胖与代谢病外科实际需要的加速康复外科诊疗规范。
Abstract:
Objective To investigate the preliminary application value of enhanced recovery aftersurgery (ERAS) in bariatric surgery. Methods Clinical data of 25 patients undergoing laparoscopicbariatric surgery in Department of Hepatobiliary Surgery, the Second People’s Hospital of Qujing fromFebruary 2013 to September 2015 were retrospectively studied. The informed consents of all patients wereobtained and the local ethical committee approval had been received. All the patients were divided into theERAS group (the study group) and the non-ERAS group (the control group) according to whether ERASwas implemented or not. Fourteen patients were included into the study group, of whom 5 were males and9 were females with an average age of (31±8) years old. Eleven patients were included into the controlgroup, of whom 4 were males and 7 were females with an average age of (33±9) years old. The measures ofERAS included low fat diet, prophylactic antibiotics preoperatively; epidural anesthesia, low tidal volumeventilation intraoperatively; early oral feeding and off-bed activity postoperatively. The incidence ofpostoperative complications, anal exsufflation time, postoperative hospital stay and the total hospitalizationexpenditure were compared between the two groups. The comparison of data between the two groups wasconducted using t test and Fisher’s exact test. Results All the patients received laparoscopic bariatricsurgery successfully without severe complications. Nausea and vomiting occurred in 4 patients of the study group postoperatively, which was significantly less than 7 of the control group (P<0.05). The analexsufflation time of the study group was (2.6±0.6) d, which was significantly shorter than (3.4±0.9) d of thecontrol group (t=–2.313, P<0.05). The postoperative hospital stay of the study group was (7.2±1.1) d, whichwas significantly shorter than (8.2±0.6) d of the control group (t=–2.715, P<0.05). The total hospitalizationexpenditure of the study group was (46±3) thousand yuan, which was significantly lower than (49±3)thousand yuan of the control group (t=–2.203, P<0.05). Conclusions ERAS is safe and feasible forlaparoscopic bariatric surgery, and it’s necessary to formulate an ERAS guideline meeting the actual needof bariatric and metabolic surgery in China.

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备注/Memo

备注/Memo:

通讯作者:方登华,Email:31765270@qq.com
更新日期/Last Update: 2016-03-30