在接受择期手术的营养不良和营养良好的患者中使用 ERAS 协议：问卷调查研究。

The use of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery: a questionnaire study.

机构信息

Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Poland.

Student Research Group, Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Poland.

出版信息

Anaesthesiol Intensive Ther. 2023;55(5):330-334. doi: 10.5114/ait.2023.134190.

DOI:10.5114/ait.2023.134190

PMID:38282499

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10801458/

Abstract

INTRODUCTION

Enhanced recovery after surgery (ERAS) is a modern approach to perioperative management. This study aimed to evaluate compliance with certain aspects of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery.

MATERIAL AND METHODS

A questionnaire study was conducted among 197 patients undergoing elective surgery at the university hospital. We divided patients into two groups according to nutritional status.

RESULTS

The study's results showed that 67 patients (34%) lost weight before admission (the weight-loss group). Twenty-five participants (37%) in the weight-loss group and 15 patients (12%) in the preserved-weight group underwent surgery due to cancer ( P < 0.001). More patients in the weight loss group (45 of 67) than in the preserved-weight group (40 of 129, P < 0.001) limited their food intake a week before the surgery. The preserved-weight group participants were mobilized earlier than the weight-loss group ( P = 0.04). The median number of hours since drinking their last fluids and eating their last meals before the surgery were 12.2 hours and 25.4 hours for both groups, respectively. Only eight patients received preoperative carbohydrate loading. We found higher serum protein concentrations in the preserved-weight group (7.10 [0.5] vs. 6.92 [0.71], P = 0.023); however, white blood cell count was higher in the weight-loss group (7.85 (2.28) vs.7.10 (0.50), P = 0.04). Both groups were highly satisfied with their hospital treatments.

CONCLUSIONS

Our study revealed relatively high malnutrition in patients undergoing elective surgery. As a standard of perioperative care in the studied centre, the ERAS protocol implementation level is low.

摘要

简介

术后加速康复（ERAS）是一种围手术期管理的现代方法。本研究旨在评估营养不良和营养良好的择期手术患者对 ERAS 方案某些方面的依从性。

材料和方法

在大学医院对 197 名择期手术患者进行了问卷调查研究。我们根据营养状况将患者分为两组。

结果

研究结果显示，197 名患者中有 67 名（34%）在入院前体重减轻（体重减轻组）。体重减轻组中有 25 名（37%）患者和保留体重组中有 15 名（12%）患者因癌症接受手术（P<0.001）。体重减轻组（45 名）比保留体重组（40 名）更多的患者在手术前一周限制饮食（P<0.001）。保留体重组的患者比体重减轻组更早地开始活动（P=0.04）。两组术前最后一次饮水和最后一次进食之间的中位时间分别为 12.2 小时和 25.4 小时。仅 8 例患者接受了术前碳水化合物负荷。我们发现保留体重组的血清蛋白浓度较高（7.10 [0.5] vs. 6.92 [0.71]，P=0.023）；然而，体重减轻组的白细胞计数较高（7.85（2.28）vs. 7.10（0.50），P=0.04）。两组患者均对其住院治疗非常满意。