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加速康复外科理念在腹腔镜治疗小儿急性阑尾炎中的临床应用。

Clinical application of enhanced recovery after surgery concept in laparoscopic treatment of pediatric acute appendicitis.

机构信息

Department of Clinical Medicine, Jining Medical University, N45 Jianshe South Road Rencheng District, Jining, 272013, Shandong Province, China.

Department of Hernia and Pediatric Surgery, Quzhou People's Hospital, Smart New City Minjiang Avenue No. 100, Quzhou, 324000, Zhejiang Province, China.

出版信息

Pediatr Surg Int. 2023 Apr 11;39(1):178. doi: 10.1007/s00383-023-05439-5.

Abstract

BACKGROUND

This study assesses whether enhanced recovery after surgery (ERAS) is beneficial in treating acute appendicitis in pediatrics by laparoscopic techniques.

METHOD

The children with acute appendicitis (n = 116) were divided into the ERAS group (n = 54) and the control group (n = 62). Then the preoperative data, intraoperative observation indexes, and postoperative data were analyzed.

RESULTS

There was no significant difference in preoperative data and intraoperative observation indexes between the two groups. C-reactive protein (CRP) and white blood cell (WBC) in the ERAS group were significantly lower than those in the control group 3 days after the operation. Moreover, no significant difference in the visual analog score (VAS) between the two groups 3 days after the operation, but the other postoperative observation indexes in the ERAS group were significantly better than those in the control group. Nausea and vomiting in the ERAS group were significantly lower than those in the control group, with no significant difference in other complications between the two groups.

CONCLUSION

ERAS could improve children's comfort, reduce some postoperative complications, reduce hospitalization expenses, and speed up recovery from acute appendicitis treated by laparoscopy. Therefore, it has clinical application value.

摘要

背景

本研究评估了加速康复外科(ERAS)是否有益于通过腹腔镜技术治疗小儿急性阑尾炎。

方法

将急性阑尾炎患儿(n=116)分为 ERAS 组(n=54)和对照组(n=62)。然后分析了术前数据、术中观察指标和术后数据。

结果

两组患儿的术前数据和术中观察指标无明显差异。ERAS 组术后 3 天 C 反应蛋白(CRP)和白细胞(WBC)明显低于对照组。此外,术后 3 天两组患者的视觉模拟评分(VAS)无明显差异,但 ERAS 组的其他术后观察指标明显优于对照组。ERAS 组恶心、呕吐的发生率明显低于对照组,两组其他并发症无明显差异。

结论

ERAS 可提高患儿舒适度,减少部分术后并发症,降低住院费用,加快腹腔镜治疗的急性阑尾炎患儿康复速度。因此,具有临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3044/10089994/7f65c9895aae/383_2023_5439_Fig1_HTML.jpg

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