摘要
目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念在经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)治疗胆总管结石中的应用价值。方法选择2014年7月至2017年7月在深圳市南山区人民医院肝胆外科行ERCP手术治疗的胆总管结石患者151例为研究对象,将其分为ERAS组(n=67)和对照组(n=84),比较两组患者的手术时间、首次进食时间、术后4小时及次晨7点的白细胞计数、血淀粉酶、血红蛋白、住院天数、住院费用及术后并发症的情况。结果 ERAS组患者的首次进食时间、首次下床活动时间显著早于对照组(P<0.05),术后4小时及次晨7点血淀粉酶含量均显著低于对照组患者(P<0.05);ERAS组患者的住院天数、住院费用均显著少于对照组(P<0.05),恶心/呕吐、腹胀、急性胰腺炎发生率均显著低于对照组患者(P<0.05);ERAS组和对照组患者的手术时间、术后4小时及次晨7点白细胞计数、术后4小时及次晨7点血红蛋白水平、消化道出血发生率对比均无显著差异(P>0.05)。结论 ERAS理念在ERCP治疗胆总管结石中应用安全、有效。
Objective To explore the application of the concept of enhanced recovery after surgery(ERAS)in the treatment of choledocholithiasis by endoscopic retrograde cholangiopancreatography(ERCP).Method Choose 151 patients with calculus of common bile duct from July 2014 to July 2017,surgery for surgical treatment of ERCP in department of hepatobiliary of Shenzhen Nanshan District people's Hospital,they were divided into ERAS group(n=67)and control group(n=84),the two groups were compared the difference between surgery time,eating for the first time,get out of bed for the first time,WBC after 4 hours of surgery,WBC at 7 o'clock in the morning,blood amylase after 4 hours of surgery,blood amylase at 7 o'clock in the morning,hemoglobin after 4 hours of surgery,hemoglobin at 7 o'clock in the morning,and postoperative hospitalization days,hospitalization time,hospitalization expenses and postoperative complications.Result The first feeding time,ambulation time in ERAS group were significantly earlier than control group,blood amylase after 4 hours of surgery and at 7 o'clock in the next morning were significantly lower than control group(P<0.05);length of stay,cost of hospitalization in ERAS group were significantly lower than control group(P<0.05);the proportion of nausea/vomiting,Abdominal distention and acute pancreatitis in ERAS group were significantly lower than control group(P<0.05);operation time,the white blood cell,blood amylase were no statistical significance between ERAS group and control group(P>0.05);hemorrhage of digestive tract were no significant difference occurred in ERAS group and control group(P>0.05).Conclusion The ERAS concept is safe and effective in the treatment of calculus common bile duct by ERCP.
作者
索质君
郑永彬
刘利平
王甫誉
李琴
徐菲
SUO Zhi-jun;ZHENG Yong-bin;LIU Li-ping;WANG Fu-yu;LI Qin;XU Fei(Department of Hepatobiliary and Pancreatic Surgery,Shenzhen Nanshan District People's Hospital,Guangdong,Shenzhen 518052,China;Department of Hepatobiliary Surgery,Shenzhen People's Hospital,Guangdong,Shenzhen 518020,China;Digestive Endoscopy Center,Shenzhen Nanshan District People's Hospital,Guangdong,Shenzhen 518052,China)
出处
《中国医学前沿杂志（电子版）》
2018年第5期111-114,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
国家自然科学青年基金(81402041)
关键词
加速康复外科
经内镜逆行胰胆管造影
胆总管结石
Enhanced recovery after surgery
Endoscopic retrograde cholangiopancreatography
Choledocholithiasis
