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小儿先天性脊柱侧凸手术后的加速康复。

Enhanced recovery after surgery in children with congenital scoliosis.

机构信息

Department of Spine, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Zhengzhou, China.

出版信息

Sci Rep. 2024 Aug 20;14(1):19270. doi: 10.1038/s41598-024-66476-1.

Abstract

To assess the impact of Enhanced Recovery After Surgery (ERAS) protocol in children undergoing corrective surgery for congenital scoliosis. A retrospective analysis was conducted on children undergoing surgical correction for congenital scoliosis, with participants categorized into either the ERAS group or the control group. Comparative evaluations were made across clinical, surgical, laboratory, and quality of life parameters. Following propensity score matching, 156 patients were analyzed. Within the initial 3 days following surgery, the ERAS cohort demonstrated lower pain intensity and exhibited higher daily oral intake compared to their counterparts in the control group. A mere 14.1% of patients in the ERAS group experienced a peak body temperature exceeding 38.5°, illustrating a significantly lower incidence compared to the 33.3% recorded in the control group. The ERAS cohort displayed expedited timeframes for the onset of initial bowel function and postoperative discharge when contrasted with the control group. Levels of IL-6 assessed on the third day post-surgery were markedly reduced in the ERAS group in comparison to the control group. Noteworthy is the similarity observed in postoperative hemoglobin and albumin levels measured on the first and third postoperative days between the two groups. Assessments of quality of life using SF-36 and SRS-22r questionnaires revealed comparable scores across all domains in the ERAS group when juxtaposed with the control cohort. ERAS protocol has demonstrated a capacity to bolster early perioperative recovery, alleviate postoperative stress responses, and uphold favorable quality of life outcomes in children undergoing corrective surgery for congenital scoliosis.

摘要

评估加速康复外科(ERAS)方案在儿童先天性脊柱侧凸矫正手术中的影响。对接受先天性脊柱侧凸矫正手术的儿童进行回顾性分析,将参与者分为 ERAS 组和对照组。对临床、手术、实验室和生活质量参数进行了比较评估。经过倾向评分匹配,对 156 例患者进行了分析。在手术后的前 3 天内,ERAS 组的疼痛强度较低,与对照组相比,每日口服摄入量较高。ERAS 组仅有 14.1%的患者体温峰值超过 38.5°C,与对照组的 33.3%相比,发生率显著降低。与对照组相比,ERAS 组在初始肠蠕动和术后出院时间上更快。与对照组相比,在手术后第 3 天评估的 IL-6 水平明显降低。值得注意的是,两组在术后第 1 天和第 3 天测量的术后血红蛋白和白蛋白水平相似。使用 SF-36 和 SRS-22r 问卷评估生活质量,与对照组相比,ERAS 组在所有领域的评分均相似。ERAS 方案已被证明能够增强儿童先天性脊柱侧凸矫正手术的早期围手术期恢复,减轻术后应激反应,并维持良好的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87e5/11335747/3a2041ad1e2e/41598_2024_66476_Fig1_HTML.jpg

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