加速康复外科理念在腹腔镜下宫颈癌根治术中的管理实践及效果评价

关键词: 加速康复外科;宫颈癌根治术;腹腔镜

沈馨,王富兰,赵庆华,肖明朝,唐均英,闵苏,王华平   

  • Vol. 2 No. 1 Feb. 2021
  • DIO:10.12180/j.issn.2096-7721.2021.01.008 发布日期:2021-04-11 阅读数:700
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  • 作者简介:

目的:制定适用于腹腔镜下宫颈癌根治术的妇科加速康复外科(Enhanced recovery after 叩urgery, ERAS)方案,评价该方案临床应用效果。方法:组建妇科 ERAS 多学科团队,筛选最佳实施策略,确立妇科  ERAS 方案,进行人员培训和方案实施,固化有效措施,并在院内交流实施经验。选择方案实施前 146 例宫颈癌患者为对照组,实施后 128 例宫颈癌患者为试验组,比较两组患者术后恢复情况。结果:试验组术后并发症总发生率为21.09%,显著低于对照组(38.36%),差异有统计学意义(P<0.05)。两组患者术后住院日、住院费用和术后 p="">0.05)。试验组术后初次下床活动时间、胃肠功能恢复时间均显著低于对照组(P<0.05)。结论:将细节落至实处的妇科加速康复外科方案可安全应用于腹腔镜下宫颈癌根治术,缩短患者术后身体功能恢复时间。

Objective: To develop and evaluate the effect of the gynecological ERAS program on patient with cervical cancer underwent laparocopic radical hyterectomy(LRH). Methods: An ERAS expert panel wa etablihed to develop an optimal trategy for peronnel training and olution implementation, the proved experience wa promoted to other department in the hopital. 146 patient with cervical cancer were elected into control group and given conventional approache, 128 patient with cervical cancer underwent gynecological ERAS into experimental group. Potoperative recovery indexe between two group were analyzed and compared. Results: The total incidence of potoperative complication in the experimental group wa 21.09%, ignificantly lower than that in the control group (38.36%), the difference wa tatitically ignificant (P<0.05). 30="" no="" ignificant="" difference="" were="" found="" on="" hopital="" cot="" and="" readmiion="" rate="" day="" after="" urgery="" between="" the="" two="" group="" p="">0.05). The time to ambulation, time to recovery of bowel function in the experimental group were ignificantly horter than thoe in the control group (P<0.05). Conclusion: The well-conducted gynecological ERAS program can be afely applied to patient with cervical cancer undergoing LRH, which can effectively horten the recovery time after urgery.