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小儿阑尾切除术患者采用加速康复理念的回顾性队列研究:一所三级大学医院的研究。

Enhanced recovery concepts in paediatric patients who underwent appendectomy: a retrospective cohort study at a tertiary university hospital.

机构信息

Department of General Surgery, Division of Paediatric Surgery, School of Medicine, The University of Jordan, Amman, Jordan.

School of Medicine, The University of Jordan, Amman, Jordan.

出版信息

J Int Med Res. 2023 Feb;51(2):3000605231158524. doi: 10.1177/03000605231158524.

Abstract

OBJECTIVE

To investigate if the implementation of enhanced recovery after surgery (ERAS) pathways could be effective in paediatric patients undergoing appendectomy.

METHODS

This retrospective study analysed the data from patients aged ≤18 years that underwent appendectomies. The data collected included age, sex, application of enhanced recovery concepts (ERCs) and clinical outcomes.

RESULTS

A total of 93 paediatric patients were retrospectively categorized into two groups: patients in group 1 did not experience the use of ERCs during their appendectomies; and patients in group 2 had ERCs applied during their appendectomies. Patients in both groups were exposed to some elements of ERAS, including preoperative patient/parent counselling, limited fasting durations, antibiotic prophylaxis and no bowel preparations. Duration of hospital stay was significantly longer in group 1 compared with group 2 (3.47 ± 1.81 days versus 2.24 ± 1.52 days, respectively. There were no significant differences between the two groups in term of postoperative pain control, hospital cost, readmissions, reoperations and emergency room visits.

CONCLUSION

Implementing ERCs in paediatric patients undergoing appendectomies provided a significant improvement in patient recovery with a shorter hospital stay, with no increase in postoperative pain, hospital cost, rate of readmission and reoperation.

摘要

目的

研究在小儿阑尾切除术中实施加速康复外科(ERAS)方案是否有效。

方法

本回顾性研究分析了年龄≤18 岁行阑尾切除术患者的数据。收集的数据包括年龄、性别、增强恢复概念(ERCs)的应用和临床结果。

结果

共回顾性分析了 93 例儿科患者,将其分为两组:组 1 患者在阑尾切除术中未经历 ERCs;组 2 患者在阑尾切除术中应用了 ERCs。两组患者均接受了 ERAS 的一些措施,包括术前患者/家长咨询、限制禁食时间、抗生素预防和不进行肠道准备。与组 2 相比,组 1 的住院时间明显更长(分别为 3.47±1.81 天和 2.24±1.52 天)。两组患者在术后疼痛控制、住院费用、再入院率、再手术率和急诊室就诊率方面无显著差异。

结论

在小儿阑尾切除术中实施 ERCs 可显著改善患者的康复情况,缩短住院时间,而不会增加术后疼痛、住院费用、再入院率和再手术率。

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