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基于术后加速康复管理模式在小儿门诊手术中的安全性和可行性。

Safety and feasibility of enhanced recovery after surgery-based management model for ambulatory pediatric surgical procedures.

作者信息

Fan Gui-Quan, Zhang Xin-Dan, He Yong-Ke, Lu Xiao-Gang, Zhong Ji-Yong, Pang Zong-Yang, Gan Xi-Yang

机构信息

Pediatric Surgery, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang 615000, Sichuan Province, China.

出版信息

World J Clin Cases. 2024 Aug 6;12(22):4965-4972. doi: 10.12998/wjcc.v12.i22.4965.

Abstract

BACKGROUND

There is still some room for optimizing ambulatory pediatric surgical procedures, and the preoperative and postoperative management quality for pediatric patients needs to be improved.

AIM

To discuss the safety and feasibility of the enhanced recovery after surgery (ERAS)-based management model for ambulatory pediatric surgical procedures.

METHODS

We selected 320 pediatric patients undergoing ambulatory surgery from June 2023 to January 2024 at The First People's Hospital of Liangshan Yi Autonomous Prefecture. Of these, 220 received ERAS-based management (research group) and 100 received routine management (control group). General information, postoperative ambulation activities, surgical outcomes (operation time, postoperative gastrointestinal ventilation time, and hospital stay), postoperative pain visual analogue scale, postoperative complications (incision infection, abdominal distension, fever, nausea, and vomiting), and family satisfaction were compared.

RESULTS

The general information of the research group (sex, age, disease type, single parent, family history, ) was comparable to that of the control group ( > 0.05), but the rate of postoperative (2 h, 4 h, and 6 h after surgery) ambulation activities was statistically higher ( < 0.01), and operation time, postoperative gastrointestinal ventilation time, and hospital stay were markedly shorter ( < 0.05). The research group had lower visual analogue scale scores ( < 0.01) at 12 h and 24 h after surgery and a lower incidence of total postoperative complications than the control group ( = 0.001). The research group had higher family satisfaction than the control group ( = 0.007).

CONCLUSION

The ERAS-based management model was safe and feasible in ambulatory pediatric surgical procedures and worthy of clinical promotion.

摘要

背景

门诊小儿外科手术的优化仍有一定空间,小儿患者围手术期管理质量有待提高。

目的

探讨基于加速康复外科(ERAS)的门诊小儿外科手术管理模式的安全性和可行性。

方法

选取2023年6月至2024年1月在凉山彝族自治州第一人民医院行门诊手术的320例小儿患者。其中,220例接受基于ERAS的管理(研究组),100例接受常规管理(对照组)。比较两组患者的一般资料、术后活动情况、手术结局(手术时间、术后胃肠通气时间、住院时间)、术后疼痛视觉模拟评分、术后并发症(切口感染、腹胀、发热、恶心、呕吐)及家属满意度。

结果

研究组的一般资料(性别、年龄、疾病类型、单亲情况、家族史等)与对照组相比差异无统计学意义(P>0.05),但术后(术后2 h、4 h和6 h)活动率在统计学上更高(P<0.01),手术时间、术后胃肠通气时间和住院时间明显更短(P<0.05)。研究组术后12 h和24 h的视觉模拟评分更低(P<0.01),术后总并发症发生率低于对照组(P=0.001)。研究组的家属满意度高于对照组(P=0.007)。

结论

基于ERAS的管理模式在门诊小儿外科手术中安全可行,值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07e3/11238811/a129adb8c78d/WJCC-12-4965-g001.jpg

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