Department of Hepatobiliary Surgery, Chongzhou People's Hospital, 318 Yongkang East Road, Chongzhou City, Chengdu, 611230, Sichuan Province, China.
Biomed Eng Online. 2024 Nov 29;23(1):123. doi: 10.1186/s12938-024-01303-2.
To explore the application effect of enhanced recovery after surgery (ERAS) for patients with hepatolithiasis undergoing hepatectomy.
A retrospective comparative analysis was performed on the clinical data of 120 patients with hepatolithiasis who were admitted to the Department of Hepatobiliary Surgery in our hospital between December 2017 and May 2022 using convenience sampling.
There were differences in the impact of different management modes on blood glucose and visual analogue scale (VAS) scores between the two groups of patients (F = 32.581, F = 41.472, all P < 0.001). The average blood glucose levels in the traditional group were higher than those in the ERAS group at two time points, and the VAS scores in the former group were higher than those in the latter at 6, 12 and 24 h after surgery. The remifentanil dosage (49.89 ± 12.12 vs 57.84 ± 11.43 mL, t = - 2.475, P = 0.016), patient-controlled analgesia frequency (3.83 ± 2.23 vs 5.57 ± 3.52 times, t = - 2.481, P = 0.015) and analgesic supplementation frequency (0.57 ± 0.73 vs 1.07 ± 1.02 times, t = - 2.653, P = 0.010) in the ERAS group were all lower than those in the traditional group. Different management modes had different effects on the levels of procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP) and white blood cell count (WBC) in the two groups of patients (F = 45.371, F = 43.466, F = 51.364, F = 65.674, all P < 0.001). The levels of PCT, IL-6, CRP and WBC in the ERAS group were lower than those in the traditional group at three time points: postoperative day 1, 7 and 14. The postoperative hospital stay (8.41 ± 2.55 vs 11.61 ± 3.34 d, t = - 7.812, P < 0.001) and proportion of postoperative complications (9.61% vs 26.47%, χ = 5.403, P = 0.020) in the ERAS group were lower than those in the traditional group.
The application of ERAS effectively reduces the perioperative stress response, shortens the postoperative length of hospital stay and lowers the overall incidence of postoperative complications in patients with hepatolithiasis.
探讨加速康复外科（ERAS）在肝内胆管结石患者肝切除术中的应用效果。
采用便利抽样法，选取 2017 年 12 月至 2022 年 5 月我院肝胆外科收治的 120 例肝内胆管结石患者的临床资料进行回顾性对比分析。
两组患者不同管理模式对血糖和视觉模拟评分（VAS）的影响不同（F=32.581，F=41.472，均 P<0.001）。传统组患者在两个时间点的平均血糖水平均高于 ERAS 组，术后 6、12、24 h 时 VAS 评分均高于 ERAS 组。瑞芬太尼用量（49.89±12.12比 57.84±11.43 mL，t=-2.475，P=0.016）、患者自控镇痛（PCA）次数（3.83±2.23 比 5.57±3.52 次，t=-2.481，P=0.015）和镇痛补救次数（0.57±0.73 比 1.07±1.02 次，t=-2.653，P=0.010）均低于传统组。不同管理模式对两组患者降钙素原（PCT）、白细胞介素-6（IL-6）、C 反应蛋白（CRP）和白细胞计数（WBC）水平的影响不同（F=45.371，F=43.466，F=51.364，F=65.674，均 P<0.001）。ERAS 组患者在术后第 1、7、14 天 PCT、IL-6、CRP 和 WBC 水平均低于传统组。ERAS 组术后住院时间（8.41±2.55 比 11.61±3.34 d，t=-7.812，P<0.001）和术后并发症总发生率（9.61%比 26.47%，χ²=5.403，P=0.020）均低于传统组。
ERAS 的应用可有效减轻肝内胆管结石患者围手术期应激反应，缩短术后住院时间，降低术后并发症总发生率。
