协议指导的围手术期护理在促进头颈部肿瘤手术后恢复中的作用：机构经验。

Role of protocol-guided perioperative care to enhance recovery after head and neck neoplasm surgery: An institutional experience.

机构信息

Department of Anaesthesiology, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, India.

Institute of Medical Sciences Mangalagiri, Mangalagiri, India.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2023 Nov;70(9):491-500. doi: 10.1016/j.redare.2023.09.002. Epub 2023 Sep 7.

DOI:10.1016/j.redare.2023.09.002

PMID:37678465

Abstract

BACKGROUND

Enhanced recovery after surgery (ERAS) improve recovery after surgery. This study aimed to determine whether ERAS leads to a decrease in stay in the hospital and improves global and functional recovery after head and neck neoplasms surgery.

METHODS

We performed a prospective case and historical control study after the ERAS application. The hospital database selected 50 confirmed eligible patients in control non-ERAS group. Prospectively 54 patients were included in the ERAS group. The primary outcome was time to readiness for discharge (TRD); secondary outcomes were the length of stay (LOS), readmission rate of up to 30 days and Quality of recovery score QoR-15. Data were compared with appropriate parametric and nonparametric tests.

RESULTS

Baseline demographic data of patients were comparable between the two groups. Patients in ERAS group had significantly shorter TRD compared to the non-ERAS group 8 (6-10) vs 11 (8-16); p-value = 0.002. LOS was also significantly shorter in the ERAS group compared to the non-ERAS group [8 (7-11) vs 12 (9-17); p-value = 0.002]. Readmission at 30-days was no different, with six patients in each group. QoR-15 score was statistically better in ERAS group (94.88 ± 12.50) compared to non-ERAS group (85.44 ± 12.68) [p value < 0.001].

CONCLUSION

Implementing the ERAS programme decreased TRD and LOS and improved patient-reported recovery outcome QoR-15 in head and neck neoplasms surgery.

摘要

背景

手术后加速康复（ERAS）可改善手术后的恢复情况。本研究旨在确定 ERAS 是否会减少住院时间并改善头颈部肿瘤手术后的整体和功能恢复。

方法

在 ERAS 应用后，我们进行了前瞻性病例对照研究。医院数据库在对照非 ERAS 组中选择了 50 例确诊合格患者。前瞻性地纳入了 54 例 ERAS 组患者。主要结局是准备出院时间（TRD）；次要结局是住院时间（LOS）、30 天内再入院率和恢复质量评分 QoR-15。数据比较采用适当的参数和非参数检验。

结果

两组患者的基线人口统计学数据无差异。ERAS 组患者的 TRD 明显短于非 ERAS 组 8（6-10）比 11（8-16）；p 值=0.002。ERAS 组的 LOS 也明显短于非 ERAS 组 [8（7-11）比 12（9-17）；p 值=0.002]。30 天内再入院率在两组之间没有差异，每组各有 6 例患者。ERAS 组的 QoR-15 评分明显优于非 ERAS 组（94.88±12.50）比（85.44±12.68）[p 值<0.001]。