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加速康复外科在鼓室成形术和乳突根治术围手术期的应用

Application of Enhanced Recovery After Surgery in Perioperative Period of Tympanoplasty and Mastoidectomy.

作者信息

Tan Jing-Qian, Chen Yu-Bin, Wang Wei-Hao, Zhou Shao-Li, Zhou Qi-Lin, Li Peng

机构信息

Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

Ear Nose Throat J. 2021 Dec;100(10_suppl):1045S-1049S. doi: 10.1177/0145561320928222. Epub 2020 Jun 18.

Abstract

INTRODUCTION

Enhanced recovery after surgery (ERAS) protocols are a series of perioperative care to optimize preoperative preparation, prevent postoperative complications, minimize stress, and speedup recovery. Tympanoplasty and mastoidectomy are common surgical procedures for chronic suppurative otitis media.

OBJECTIVE

To compare the efficacy and safety between ERAS and conventional recovery after surgery in the perioperative period of chronic suppurative otitis media.

METHODS

From April 2018 to February 2019, a total of 84 patients scheduled for tympanoplasty and/or mastoidectomy due to chronic suppurative otitis media were involved and randomly divided into the ERAS group and the control group. The patients' preoperative anxiety, postoperative pain, and comfort level were determined by comparing the results of Self-Rating Anxiety Scale (SAS), Visual Analog Scale (VAS) and General Comfort Questionnaire (GCQ). The postoperative complications, postoperative hospital stay, and hospitalization cost were calculated.

RESULTS

The ERAS group showed a lower SAS score (30 [28-31.5] vs 35 [30-43], < .05], a higher GCQ score (88 [84-100] vs 83 [78.25-92.25], < .05), and a lower VAS score (0 [0-0] vs 1 [0-2], < .05] after surgery. No significant difference ( > .05) was observed between the ERAS group and the control group in postoperative complications, postoperative hospitalization time, and hospitalization cost, respectively.

CONCLUSION

Enhanced recovery after surgery can reduce pain and improve comfort in the perioperative period of chronic suppurative otitis media.

摘要

引言

术后加速康复(ERAS)方案是一系列围手术期护理措施,旨在优化术前准备、预防术后并发症、减轻应激并加速康复。鼓室成形术和乳突根治术是慢性化脓性中耳炎常见的外科手术。

目的

比较慢性化脓性中耳炎围手术期ERAS与传统术后康复的疗效和安全性。

方法

2018年4月至2019年2月,共有84例因慢性化脓性中耳炎计划行鼓室成形术和/或乳突根治术的患者参与研究,并随机分为ERAS组和对照组。通过比较自评焦虑量表(SAS)、视觉模拟量表(VAS)和一般舒适度问卷(GCQ)的结果,确定患者术前焦虑、术后疼痛和舒适度。计算术后并发症、术后住院时间和住院费用。

结果

ERAS组术后SAS评分较低(30[28 - 31.5]对35[30 - 43],P <.05),GCQ评分较高(88[84 - 100]对83[78.25 - 92.25],P <.05),VAS评分较低(0[0 - 0]对1[0 - 2],P <.05)。ERAS组与对照组在术后并发症、术后住院时间和住院费用方面分别未观察到显著差异(P>.05)。

结论

术后加速康复可减轻慢性化脓性中耳炎围手术期的疼痛并提高舒适度。

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