Feng SongShan, Xie Bo, Li ZhenYan, Zhou XiaoXi, Cheng Quan, Liu ZhiXiong, Tao ZiRong, Zhang MingYu
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Front Oncol. 2021 Nov 12;11:755378. doi: 10.3389/fonc.2021.755378. eCollection 2021.
To investigate whether enhanced recovery after surgery (ERAS) can promote rehabilitation of patients after neurosurgical craniotomy.
The clinical data of 100 patients with brain tumor undergoing craniotomy in the Department of Neurosurgery, Xiangya Hospital, Central South University, from January 2018 to August 2020 were collected, including 50 patients in the ERAS group and 50 patients in the control group. t-Test, Wilcoxon's rank sum test, and chi-square analysis were used to compare the clinical characteristics, prognosis, and hospitalization time between the two groups.
There was no significant difference in gender, age, and other general clinical data between the two groups ( > 0.05). The days of antiemetic drugs applied in the ERAS group were less than those in the control group (1.00 . 2.00 days, = 0.003), and the proportion of patients requiring analgesics was lower than that of the control group (30% . 52%, OR = 0.41, 95% CI 0.18-0.93, = 0.031). The time of urinary catheter removal and that of patients starting ambulation in the ERAS group were shorter than those in the control group (16.00 . 24.00 h, and 1.00 . 2.00 days, < 0.001, respectively); and the hospital length of stay (LOS) in the ERAS group was shorter than that in the control group (Total LOS, 13.00 . 15.50 days; Postoperative LOS, 7.00 . 10.00 days, < 0.001). By analyzing the prognosis of patients in the ERAS group and control group, we found that there was no significant difference in postoperative complications and Karnofsky Performance Status (KPS) score 1 month after operation between the two groups.
The application of ERAS in craniotomy can accelerate the postoperative recovery of patients without increasing the perioperative risk, which is worthy of wide application. However, whether the ERAS measures can reduce the postoperative complications and improve the prognosis of patients still needs more large-scale case validation and multicenter collaborative study.
探讨术后加速康复（ERAS）能否促进神经外科开颅术后患者的康复。
收集2018年1月至2020年8月在中南大学湘雅医院神经外科行开颅手术的100例脑肿瘤患者的临床资料，其中ERAS组50例，对照组50例。采用t检验、Wilcoxon秩和检验和卡方分析比较两组患者的临床特征、预后及住院时间。
两组患者的性别、年龄等一般临床资料差异无统计学意义（>0.05）。ERAS组应用止吐药物的天数少于对照组（1.00对2.00天，=0.003），且需要镇痛药物的患者比例低于对照组（30%对52%，OR=0.41，95%CI 0.18-0.93，=0.031）。ERAS组拔除尿管时间和患者开始下床活动时间均短于对照组（分别为16.00对24.00小时和1.00对2.00天，<0.001）；且ERAS组住院时间短于对照组（总住院时间，13.00对15.50天；术后住院时间，7.00对10.00天，<0.001）。通过分析ERAS组和对照组患者的预后，发现两组术后并发症及术后1个月的卡氏功能状态（KPS）评分差异无统计学意义。
ERAS应用于开颅手术可加速患者术后康复，且不增加围手术期风险，值得广泛应用。然而，ERAS措施能否降低术后并发症及改善患者预后仍需更多大规模病例验证及多中心协作研究。
