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一项增强康复计划改善了接受腺样体扁桃体切除术的阻塞性睡眠呼吸暂停儿童的舒适度和治疗效果:一项回顾性历史对照研究。

An enhanced recovery programme improves the comfort and outcomes in children with obstructive sleep apnoea undergoing adenotonsillectomy: A retrospective historical control study.

作者信息

Zhang Yu, Liu Dawei, Chen Xiumei, Ma Jiahai, Song Xicheng

机构信息

Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Department of Anesthesiology. Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

出版信息

Clin Otolaryngol. 2021 Jan;46(1):249-255. doi: 10.1111/coa.13655. Epub 2020 Nov 7.

Abstract

OBJECTIVE

To explore the effects of an enhanced recovery after surgery (ERAS) programme on postoperative rehabilitation in children with obstructive sleep apnoea (OSA) during the perioperative period of adenotonsillectomy.

DESIGN

A retrospective historical control study.

SETTING

Service improvement project.

PARTICIPANTS

The study included 394 children with OSA (207 males, 187 females; age range, 2.5 years to 14 years) who underwent adenotonsillectomy.

MAIN OUTCOME MEASURES

The children who had undergone adenoidal ablation and bilateral tonsillectomy were divided into an ERAS group (208 patients) treated with the combined optimisation measures and a control group (186 patients) treated with traditional measures during the perioperative period. The postoperative incidence of complications, pain scores, anxiety scores and postoperative diets in the two groups were assessed.

RESULTS

Patients in the ERAS group had significantly a lower overall complication rate and incidence of fever for 2 weeks of follow-up when compared to patients in the control group through the application of perioperative optimisation measures. Furthermore, patients in the ERAS group had less post-surgical pain, had better dietary intake at days 1, 3 and 7 after surgery and had lower preoperative anxiety scores after admission education and while waiting in the operation room.

CONCLUSION

The ERAS programme consisting of combined optimisation measures can reduce physical and psychological trauma during the perioperative period of adenotonsillectomy performed for children with OSA.

摘要

目的

探讨手术加速康复(ERAS)方案对阻塞性睡眠呼吸暂停(OSA)患儿在腺样体扁桃体切除围手术期术后康复的影响。

设计

一项回顾性历史对照研究。

设置

服务改进项目。

参与者

该研究纳入了394例接受腺样体扁桃体切除术的OSA患儿(男207例,女187例;年龄范围2.5岁至14岁)。

主要观察指标

将接受腺样体消融和双侧扁桃体切除的患儿分为ERAS组(208例患者),在围手术期采用联合优化措施治疗,以及对照组(186例患者),采用传统措施治疗。评估两组术后并发症发生率、疼痛评分、焦虑评分和术后饮食情况。

结果

通过应用围手术期优化措施,与对照组患者相比,ERAS组患者在随访2周时总体并发症发生率和发热发生率显著更低。此外,ERAS组患者术后疼痛更少,术后第1、3和7天饮食摄入更好,入院教育后和在手术室等待时术前焦虑评分更低。

结论

由联合优化措施组成的ERAS方案可减少OSA患儿腺样体扁桃体切除围手术期的身心创伤。

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