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加速康复外科(ERAS)在漏斗胸患者Nuss手术后的临床应用

Clinical application of enhanced recovery after surgery (ERAS) in pectus excavatum patients following Nuss procedure.

作者信息

Yu Pingwen, Wang Gebang, Zhang Chenlei, Liu Hongxi, Wang Yawei, Yu Zhanwu, Liu Hongxu

机构信息

Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang 110042, China.

出版信息

J Thorac Dis. 2020 Jun;12(6):3035-3042. doi: 10.21037/jtd-20-1516.

Abstract

BACKGROUND

Evaluate the effect of enhanced recovery after surgery (ERAS) protocol on postoperative recovery quality of pectus excavatum patients with Nuss procedure.

METHODS

A retrospective study was performed on patients undergoing Nuss procedure from the Department of Thoracic Surgery of The Cancer Hospital of China Medical University between September 2016 and September 2019. Patients were divided into 2 groups by perioperative management: the traditional procedure group (T group) and the ERAS strategy group (E group). The outcome measures were postoperative drainage time, postoperative hospital time, and postoperative complications measured by the Clavien-Dindo method.

RESULTS

Of the 168 patients from this time period, 148 met the inclusion criteria (75 in Group T and 73 in Group E). All operations involved in this study were completed successfully. There was no statistical difference between the 2 groups with respect to baseline demographics (P>0.05). In Group E, postoperative drainage time (2.53±0.72 3.45±2.07 days) and postoperative hospitalization time (4.96±1.48 7.71±7.78 days) were statistically significantly better than those in Group T (P<0.05). There was no difference in overall postoperative complications as measured by Clavien-Dindo score.

CONCLUSIONS

The measures of no indwelling urinary catheter (IDUC), laryngeal mask anesthesia, and indwelling tubule drainage can improve postoperative recovery quality of pectus excavatum patients following Nuss procedure.

摘要

背景

评估术后加速康复(ERAS)方案对漏斗胸患者行Nuss手术术后恢复质量的影响。

方法

对2016年9月至2019年9月在中国医科大学附属肿瘤医院胸外科接受Nuss手术的患者进行回顾性研究。根据围手术期管理将患者分为2组:传统手术组(T组)和ERAS策略组(E组)。观察指标为术后引流时间、术后住院时间以及采用Clavien-Dindo法测量的术后并发症。

结果

在该时间段的168例患者中,148例符合纳入标准(T组75例,E组73例)。本研究涉及的所有手术均成功完成。两组患者的基线人口统计学特征无统计学差异(P>0.05)。E组的术后引流时间(2.53±0.72比3.45±2.07天)和术后住院时间(4.96±1.48比7.71±7.78天)在统计学上显著优于T组(P<0.05)。Clavien-Dindo评分所测量的总体术后并发症无差异。

结论

不留置尿管、喉罩麻醉和留置细管引流等措施可提高漏斗胸患者行Nuss手术后的恢复质量。

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