摘要
目的:探索加速康复(ERAS)在简单先天性心脏病(先心病)外科手术中应用的临床可行性。方法:回顾性总结2021年1月至2023年5月在上海儿童医学中心接受体外循环下心内直视手术的136例简单先心病患儿临床资料,将36例接受ERAS康复的先心病患儿(ERAS组)和100例常规组患儿的围术期资料进行倾向性评分匹配后,比较术后恢复情况及住院费用,评估ERAS在先心病外科手术中的临床可行性。结果:2组患者的基线资料经倾向性评分匹配后,ERAS组32例和常规组52例纳入分析,组间平衡良好,年龄、体质量、身高、体外循环时间等指标差异均无统计学意义。ERAS组与常规组患者的术后呼吸机时间分别为(1.7±0.6)h对(9.9±11.3)h,引流管留置时间(3.4±0.6)d对(4.3±1.0)d,住院时间(5.2±0.8)d对(7.0±2.4)d,住院费用(55478.7±14345.0)元对(75632.0±10402.6)元,P均<0.001。结论:简单先心病如室间隔缺损和房间隔缺损可以安全顺利地进行ERAS计划,有利于促进术后康复,减少住院时间,节约住院费用。
Objective:To explore the clinical feasibility of enhanced recovery after surgery(ERAS)in patients with simple congenital cardiac defects.Methods:From January 2021 to April 2023,a total of 136 patients with simple congenital heart disease who underwent open heart surgery with cardiopulmonary bypass in Shanghai Children's Medical Center were recruited.Postoperative recovery and hospitalization cost were compared between patients receiving ERAS(n=36)and those receiving conventional scheme(n=100).Results:After propensity score matching(PSM),32 patients in ERAS group and 52 patients in conventional group were included in the analysis.There were no significant differences in age,weight,height,and cardiopulmonary bypass time between the two groups.Compared with the conventional group,the postoperative ventilator time(1.7±0.6)h vs.(9.9±11.3)h,duration of drainage(3.4±0.6)d vs.(4.3±1.0)d,duration of hospital stay(5.2±0.8)d vs.(7.0±2.4)d in ERAS group was shorter,and overall hospitalization cost(55478.7±14345.0)yuan vs.(75632.0±10402.6)yuan was lower in ERAS group(all P<0.001).Conclusion:In patients with simple congenital heart disease(such as atrial or ventricular septal defect),the ERAS program could be safely carried out and promotes postoperative recovery,and reduces hospital stay and costs.
作者
张婧怡
潘燕军
梁富帮
任逸倬
冯佳怡
殷猛
ZHANG Jingyi;PAN Yanjun;LIANG Fubang;REN Yizhuo;FENG Jiayi;YIN Meng(Department of Cardiothoracic Surgery,Shanghai Children's Medical Center,School of Meadicine,Shanghai Jiao Tong University,Shanghai 200127,China)
出处
《国际心血管病杂志》
2023年第5期313-316,共4页
International Journal of Cardiovascular Disease
基金
申康临床科技创新项目(SHDC22021213)
上海市卫健委卓越项目(20234Z0003)。
关键词
加速康复外科
先天性心脏病
手术
Enhanced recovery after surgery
Congenital heart disease
Surgery
