Zhang Jian-Guo, Li Hao-Wei, Wu Xiang-Ming, Yu Hai-Bin, Liu Yan-Hui, Qi Lin, Bai Yu, Yang Lin, Zhang Hai-Long, Wang Xiao-Yun, Jia Yue-Qi
Pediatric Surgery, Inner Mongolia Maternal and Child Health Care Hospital, Hohhot, China.
Pediatric Surgery, The Fourth Hospital of Baotou, Baotou, China.
Front Pediatr. 2023 Oct 20;11:1261191. doi: 10.3389/fped.2023.1261191. eCollection 2023.
To explore the application effect of enhanced recovery after surgery (ERAS) perioperative plan in the treatment of complex appendicitis in children, and further enrich the implementation plan of ERAS in the field of pediatric surgery.
This study selected 122 children who underwent laparoscopic complex appendectomy at Inner Mongolia Maternal and Child Health Hospital and Baotou Fourth Hospital from August 2018 to July 2022, and randomly divided them into a traditional surgery group (TS) and an enhanced recovery surgery group (ERAS). The changes of white blood cell (WBC), hypersensitive C-reactive protein (CRP), pro Calcitonin (PCT) and interleukin 6 (IL-6) before and after surgery were compared. The degree of pain, recovery time of intestinal function, length of hospital stay, hospital costs, postoperative complications and parental satisfaction were compared between the two groups.
The WBC and CRP levels in the ERAS group at 6 h after surgery, as well as the IL-6 levels on the 3rd day after surgery, were lower than those in the TS group. Meanwhile, the analgesic effect of ERAS group at 3 h and 6 h after surgery was better than that of TS group. And the ERAS group had a shorter postoperative first exhaust time, fewer overall hospital stays, and lower hospitalization costs. In addition, the ERAS group had high parental satisfaction during hospitalization. There was no statistically significant difference in postoperative complications between the two groups of children.
ERAS can promote postoperative recovery of children, reduce surgical stress, save family medical expenses, alleviate the pain of children, and improve parental satisfaction. It is a safe and effective method for treating complex appendicitis in children.
探讨手术加速康复（ERAS）围手术期方案在儿童复杂性阑尾炎治疗中的应用效果，进一步丰富ERAS在小儿外科领域的实施方案。
本研究选取2018年8月至2022年7月在内蒙古妇幼保健院和包头市第四医院行腹腔镜复杂性阑尾切除术的122例患儿，随机分为传统手术组（TS）和加速康复手术组（ERAS）。比较两组患儿手术前后白细胞（WBC）、超敏C反应蛋白（CRP）、降钙素原（PCT）及白细胞介素6（IL-6）的变化。比较两组患儿的疼痛程度、肠功能恢复时间、住院时间、住院费用、术后并发症及家长满意度。
ERAS组术后6 h的WBC和CRP水平以及术后第3天的IL-6水平均低于TS组。同时，ERAS组术后3 h和6 h的镇痛效果优于TS组。且ERAS组术后首次排气时间更短，总住院天数更少，住院费用更低。此外，ERAS组住院期间家长满意度较高。两组患儿术后并发症差异无统计学意义。
ERAS可促进患儿术后恢复，减轻手术应激，节省家庭医疗费用，减轻患儿痛苦，提高家长满意度。是治疗儿童复杂性阑尾炎的一种安全有效的方法。
