Gu Yue-Xia, Wang Xin-Yu, Xu Mei-Xia, Qian Jia-Jie, Wang Yan
Department of Nursing, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China.
Department of General Surgery, Shanghai Fourth People's Hospital School of Medicine Tongji University, Shanghai 200434, China.
World J Gastrointest Surg. 2023 Feb 27;15(2):201-210. doi: 10.4240/wjgs.v15.i2.201.
In China, as the population grows older, the number of elderly people who have died from respiratory problems has increased.
To investigate whether enhanced recovery after surgery (ERAS)-based respiratory function training may help older patients who had abdominal surgery suffer fewer pulmonary problems, shorter hospital stays, and improved lung function.
The data of 231 elderly individuals having abdominal surgery was retrospectively analyzed. Based on whether ERAS-based respiratory function training was provided, patients were divided into ERAS group ( = 112) and control group ( = 119). Deep vein thrombosis (DVT), pulmonary embolism (PE), and respiratory tract infection (RTI) were the primary outcome variables. Secondary outcome variables included the Borg score Scale, FEV1/FVC and postoperative hospital stay.
The percentage of 18.75% of ERAS group participants and 34.45% of control group participants, respectively, had respiratory infections ( = 0.007). None of the individuals experienced PE or DVT. The ERAS group's median postoperative hospital stay was 9.5 d (3-21 d) whereas the control groups was 11 d (4-18 d) ( = 0.028). The Borg score decreased on the 4 d following surgery in the ERAS group compared to the 2 d prior ( = 0.003). The incidence of RTIs was greater in the control group than in the ERAS group among patients who spent more than 2 d in the hospital before surgery ( = 0.029).
ERAS-based respiratory function training may reduce the risk of pulmonary complications in older individuals undergoing abdominal surgery.
在中国，随着人口老龄化，因呼吸问题死亡的老年人数量有所增加。
探讨基于术后加速康复（ERAS）的呼吸功能训练是否有助于腹部手术老年患者减少肺部问题、缩短住院时间并改善肺功能。
回顾性分析231例接受腹部手术的老年患者的数据。根据是否接受基于ERAS的呼吸功能训练，将患者分为ERAS组（n = 112）和对照组（n = 119）。深静脉血栓形成（DVT）、肺栓塞（PE）和呼吸道感染（RTI）为主要结局变量。次要结局变量包括Borg评分量表、第1秒用力呼气容积/用力肺活量（FEV1/FVC）和术后住院时间。
ERAS组和对照组分别有18.75%和34.45%的参与者发生呼吸道感染（P = 0.007）。所有个体均未发生PE或DVT。ERAS组术后中位住院时间为9.5天（3 - 21天），而对照组为11天（4 - 18天）（P = 0.028）。与术前2天相比，ERAS组术后第4天Borg评分降低（P = 0.003）。术前住院超过2天的患者中，对照组的RTI发生率高于ERAS组（P = 0.029）。
基于ERAS的呼吸功能训练可能降低腹部手术老年患者发生肺部并发症的风险。
