目的：探究加速康复外科联合肠内营养对机器人辅助腹腔镜肝切除术患者术后胃肠功能恢复的影响。 方法：选取 2020 年 2 月—2023 年 6 月于空军军医大学第二附属医院收治的 108 例机器人辅助腹腔镜肝切除术患者实 施前瞻性研究，按随机数字表法将其分为研究组（n=54，实施加速康复外科 + 肠内营养）与对照组（n=54，实施常 规护理 + 肠内营养）。比较两组患者胃肠功能恢复指标、胃肠道激素水平、营养指标、生活质量的差异。结果：与 对照组相比，研究组患者肠鸣音恢复时间、肛门排气时间、肛门排便时间更短，术后恶心呕吐发生率、术后肠梗阻 发生率、术后 48 h 内存在腹胀率均更低，差异有统计学意义（P<0.05）。重复测量显示，两组患者胃动素、胃泌素 的时点、组间、交互效应比较，差异有统计学意义（P<0.05），相较于术前，术后 3 d、术后 7 d 两组患者胃动素、 胃泌素均降低（P<0.05），但研究组患者均高于对照组，差异有统计学意义（P<0.05）。相较于术前，术后 7 d 对 照组患者球蛋白、血红蛋白、白蛋白、前白蛋白均降低（P<0.05），但研究组患者均高于对照组，差异有统计学意 义（P<0.05）。相较于术前，出院后 1 个月两组患者功能领域、总体健康均升高，症状领域、单测项目均降低（P<0.05）， 但研究组患者均优于对照组，差异有统计学意义（P<0.05）。结论：加速康复外科联合肠内营养应用于机器人辅助 腹腔镜肝切除术患者可有效促进术后胃肠功能恢复，改善营养指标，提高生活质量。

Objective: To explore the effect of enhanced recovery after surgery (ERAS) combined with enteral nutrition on postoperative recovery of gastrointestinal function in patients who underwent robot-assisted laparoscopic hepatectomy. Methods: A prospective study was conducted on 108 patients who underwent robot-assisted laparoscopic liver resection in the Second Affiliated Hospital of Air Force Military Medical University from February 2020 to June 2023. They were randomly divided into the study group (n=54) and the control group (n=54) using a random number table. The control group received routine nursing care and enteral nutrition, while the study group received ERAS combined enteral nutrition. The differences in gastrointestinal function recovery indicators, gastrointestinal hormone levels, nutritional indicators, and quality of life between the two groups were compared. Results: Compared with the control group, the study group had shorter bowel recovery time, ana defecation time, and lower incidence rate of postoperative nausea and vomiting, postoperative ileus and abdominal distension 48 h after surgery (P<0.05). Repeated measurements showed statistically significant differences in the timing, intergroup, and interaction effects of motilin and gastrin between the two groups (P<0.05). Compared with that before surgery, levels of GAS and MTL at 3 d and 7 d after surgery in the two groups were both decreased, while they were higher in patients of the study group than those in the control group (P<0.05). Compared with that before surgery, the control group showed a decrease in globulin, hemoglobin , albumin and prealbumin at 7 d after surgery (P<0.05), but they were higher in the study group than those in the control group (P<0.05). Compared with that before surgery, functional areas and overall health 1 month after discharge of patients in the two groups were both improved, while symptom areas and single test items were lowered (P<0.05), but they were all better in the study group than those in the control group (P<0.05). Conclusion: ERAS combined with enteral nutrition in patients who underwent robot-assisted laparoscopic hepatectomy can effectively promote postoperative recovery of gastrointestinal function, improve nutritional indicators and quality of life.

收稿日期：2024-04-28  录用日期：2024-05-23 

Received Date: 2024-04-28  Accepted Date: 2024-05-23 

基金项目：陕西省重点研发计划项目（2020SF-220） 

Foundation Item: Key R&D Plan Project of Shaanxi Province(2020SF-220) 

通讯作者：陈萌，Email：cm1045012242@163.com 

Corresponding Author: CHEN Meng, Email: cm1045012242@163.com 

引用格式：陈辉容，臧莉，张战胜，等 . 加速康复外科联合肠内营养对机器人辅助腹腔镜肝切除术患者术后胃肠功能恢复的影响 [J]. 机器人外科学杂志（中英文），2024，5（6）：1186-1191. 

Citation: CHEN H R, ZANG L, ZHANG Z S, et al. Effect of ERAS combined with enteral nutrition on postoperative recovery of gastrointestinal function in patients underwent robot-assisted laparoscopic hepatectomy[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1186-1191.

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