摘要
目的探讨加速康复外科(ERAS)策略应用于Ⅲ～Ⅳ度混合痔患者围手术期的效果。方法回顾性分析2017年1月至2017年12月广州中医药大学第二附属医院肛肠科收治的498例手术治疗的Ⅲ～Ⅳ度混合痔患者的临床资料,根据治疗策略不同将患者分为ERAS组(n=272)和传统组(n=226)。比较两组手术相关指标及术后并发症发生情况。结果两组术中出血量、术中静脉补液量、再手术率以及再住院率比较,差异均无统计学意义(均P> 0.05)。ERAS组手术时间、总住院时间和术后住院时间均较传统组缩短,术后当天静脉补液量较传统组减少,组间比较差异均有统计学意义(均P <0.05)。两组术后继发性大出血、急性尿潴留及需强效镇痛的发生率比较,差异均无统计学意义(均P> 0.05)。结论与传统治疗策略相比,ERAS策略应用于Ⅲ～Ⅳ度混合痔围手术期管理可缩短患者手术时间、总住院时间、术后住院时间,减少术后当天静脉补液量,安全性良好。
Objectives To investigate enhanced recovery after surgery(ERAS)in patients with gradeⅢ~Ⅳmixed hemorrhoids during perioperative period.Methods This was a retrospective analysis of clinical data of 498 patients who received operation for gradeⅢ~Ⅳmixed hemorrhoids in The Second Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2017 and December 2017.Patients were divided into ERAS group(n=272)and conventional group(n=226)depending on their treatment strategy.We compare indices related to surgery and incidence of postoperative complications between the two groups.Results Amount of intraoperative blood loss,amount of fluid infusion during operation,rate of re-operation,and rate of re-hospitalization did not differ between the two groups(P>0.05).Compared with conventional group,patients in the treatment group had shorter duration of operation,shorter duration of total hospitalization and postoperative hospitalization,and lower amount of postoperative fluid infusion on the day of operation(P<0.05).There was no significant difference between the two groups in incidence of postoperative secondary hemorrhage,acute urinary retention and use of strong analgesics(P>0.05).Conclusion Compared with conventional therapy,ERAS can shorten operation,overall hospitalization and postoperative hospitalization,and decrease fluid intake on the day of operation in treating patients with gradeⅢ~Ⅳmixed hemorrhoids during periopera?tive period and it was a safe treatment strategy.
作者
谭康联
范小华
张力
庄郑妃
陈宝珍
李俊苗
Tan Kanglian;Fan Xiaohua;Zhang Li;Zhuang Zhengfei;Chen Baozhen;Li Junmiao(Department of Anorectal Diseases,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong,China)
出处
《结直肠肛门外科》
2019年第2期186-190,共5页
Journal of Colorectal & Anal Surgery
基金
广东省中医药局科研基金(20152132)
关键词
混合痔
加速康复外科
传统治疗策略
mixed hemorrhoids
enhanced recovery after surgery
conventional treatment strategy
