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术后加速康复(ERAS)在腹腔镜胆囊切除术(LC)联合腹腔镜胆总管探查术(LCBDE)中的应用:一项队列研究。

Use of Enhanced Recovery After Surgery (ERAS) in Laparoscopic Cholecystectomy (LC) Combined with Laparoscopic Common Bile Duct Exploration (LCBDE): A Cohort Study.

作者信息

Zhang Nannan, Wu Gang, Zhou Yuanhang, Liao Zhiwei, Guo Jinxing, Liu Yongjun, Huang Qi, Li Xiaodong

机构信息

Department of General Surgery, Baoshan Branch of Huashan North Courtyard Affiliated to Fudan University, (Renhe Hospital, Baoshan District, Shanghai), Shanghai, China (mainland).

出版信息

Med Sci Monit. 2020 Sep 12;26:e924946. doi: 10.12659/MSM.924946.

Abstract

BACKGROUND The have been few reports on use of ERAS in LC combined with LCBDE to promote postoperative recovery of patients. Therefore, the purpose of this cohort study was to explore the use of ERAS in patients who underwent LC combined with LCBDE. MATERIAL AND METHODS We collected clinical data of 445 patients who underwent elective laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration from January 2015 to February 2019 in our hospital and divided the patients into an E-LC group and an LC group. The stress response index, postoperative complication rate, and postoperative rehabilitation effect of the 2 groups were compared and analyzed. RESULTS The WBC count and CRP levels in the E-LC group were significantly lower than those of the LC group 1 day after surgery (p<0.05). In terms of the postoperative complications, the incidence of nausea, incisional pain, and vomiting in the E-LC group were lower than in the LC group, and the differences were statistically significant (p<0.05). In terms of the postoperative rehabilitation efficacy, flatus time and length of hospital stay after surgery in the E-LC group were significantly shorter than those in the LC group (p<0.05). CONCLUSIONS Use of ERAS in the perioperative period in patients who underwent LC combined with LCBDE reduces the stress response and postoperative complications and accelerates postoperative rehabilitation.

摘要

背景 关于在腹腔镜胆囊切除术(LC)联合腹腔镜胆总管探查术(LCBDE)中使用加速康复外科(ERAS)促进患者术后恢复的报道较少。因此,本队列研究的目的是探讨ERAS在接受LC联合LCBDE的患者中的应用。材料与方法 我们收集了2015年1月至2019年2月在我院接受择期腹腔镜胆囊切除术联合腹腔镜胆总管探查术的445例患者的临床资料,并将患者分为ERAS-LC组和LC组。比较并分析两组的应激反应指标、术后并发症发生率及术后康复效果。结果 术后1天,ERAS-LC组的白细胞计数和CRP水平显著低于LC组(p<0.05)。在术后并发症方面,ERAS-LC组恶心、切口疼痛和呕吐的发生率低于LC组,差异有统计学意义(p<0.05)。在术后康复疗效方面,ERAS-LC组术后排气时间和住院时间明显短于LC组(p<0.05)。结论 在接受LC联合LCBDE的患者围手术期使用ERAS可减轻应激反应,减少术后并发症,并加速术后康复。

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