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被标记为结直肠手术的GRACE(法语区外科手术后改良康复小组)参考中心:其对列日大学医院强化康复计划实施的影响。

Labelling as reference Centre of GRACE (Groupe francophone de Réhabilitation Améliorée après ChirurgiE) for colorectal surgery: its impact on the implementation of enhanced recovery programme at the University Hospital of Liège.

作者信息

Daenen Coralie, Coimbra Carla, Hans Grégory, Joris Jean

机构信息

a Department of Anaesthesiology , CHU Liège, University of Liège , Liège , Belgium.

b Service of Abdominal Surgery , CHU Liège, University of Liège , Liège , Belgium.

出版信息

Acta Chir Belg. 2018 Oct;118(5):294-298. doi: 10.1080/00015458.2018.1427837. Epub 2018 Jan 15.

Abstract

BACKGROUND

Enhanced recovery programme (ERP) has been used in our hospital since 2005 for selected colorectal surgeries. Since October 2015, after labelling as GRACE reference centre, we included all patients scheduled for elective colorectal surgery in this programme. We assessed the impact of our labelling on the implementation of ERP.

METHODS

Results of our first 100 patients entered in the GRACE database were analyzed: length of stay, complications, readmission, adherence to the protocol. These results are compared to those of the last 100 patients undergoing colorectal surgery before our labelling.

RESULTS

Patients' characteristics in both groups were similar. The complications rate was similar in both groups. The global length of hospital stay was 4 [5] days vs. 8.5 [8] (median [IQR]), respectively after and before labelling; p < .001. The duration of hospitalization for the different subgroups (age, surgical approach, types of surgery) were significantly shorter after our labelling (respectively: p < .001, p < .01, and p < .05).

CONCLUSIONS

Our results demonstrate that labelling as reference centre increases the efficiency of the implementation of ERP. The fact that all subgroups of patients benefit from ERP must encourage inclusion of all patients undergoing elective colorectal surgery in ERP.

摘要

背景

自2005年起,我院对部分结直肠手术采用了加速康复计划(ERP)。自2015年10月被标记为GRACE参考中心后,我们将所有计划进行择期结直肠手术的患者纳入该计划。我们评估了这一标记对ERP实施的影响。

方法

分析录入GRACE数据库的前100例患者的结果:住院时间、并发症、再入院情况、方案依从性。将这些结果与标记前最后100例接受结直肠手术的患者的结果进行比较。

结果

两组患者的特征相似。两组的并发症发生率相似。标记后和标记前的总体住院时间分别为4[5]天和8.5[8]天(中位数[四分位间距]);p<0.001。标记后不同亚组(年龄、手术方式、手术类型)的住院时间显著缩短(分别为:p<0.001、p<0.01和p<0.05)。

结论

我们的结果表明,被标记为参考中心可提高ERP实施的效率。所有患者亚组均从ERP中获益这一事实,必定会促使将所有接受择期结直肠手术的患者纳入ERP。

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