摘要:
目的 探讨加速康复外科 (ERAS) 理念在婴儿先天性十二指肠梗阻中的应用价值.方法 回顾性分析昆明市儿童医院NICU病房2015年1月至2017年12月接受手术治疗的71例先天性十二指肠梗阻患儿的临床资料, 根据家长的意愿实施分组, 即ERAS组32例和对照组39例, ERAS组采用加速康复外科的新型围手术期干预措施, 对照组采用传统的围手术期诊疗方法, 观察2组术后开奶时间, 住院时间、住院费用、并发症的发生及术后体重增长情况等指标.结果 ERAS组与对照组患儿术后开奶时间比较ERAS组为 (59±12) h, 对照组为 (138±31) h, 差异有统计学意义 (P<0.05) .ERAS组总住院时间为 (9.5±2.5) d, 住院费用为 (15.3±2.5) 千元, 明显低于对照组的 (16±2.7) d和 (19.6±3.1) 千元 (P<0.05) .出院后随访812周, 2组患儿术后并发症发生率和术后体重增长情况比较, 差异无统计学意义 (P>0.05) , 但ERAS组的体重增长幅度要快于对照组.结论 实施ERAS可以缩短先天性十二指肠梗阻手术患儿的住院时间, 减少住院费用, 并不增加并发症的发生率, 在先天性十二指肠梗阻手术中应用是安全可行的.
Abstract:
Objective To explore the application value of enhanced recovery after surgery (ERAS) in the infants with congenital duodenal obstruction. Me thods The clinical data of 71 infants with congenital duodenal obstruction who underwent operation in Kunming Children's Hospital from January 2015 to December 2017 were retrospectively analyzed. The infants were divided, according to the will of their parents, into ERAS group (n=32) and the control group (n=39) , and a new type of perioperative surgical intervention was adopted in ERAS group while traditional perioperative treatment was applied in the control group. First lactation, length of hospital stay, hospital expenses, complications and postoperative body weight growth were observed.Re s ults There was significant difference in the first lactation between the two groups (P<0.05) , (59±12) h and in ERAS group (138±31) h in control group (P<0.05) .The total length of hospital stay and hospital expenses in ERAS group (9.5± 2.5) d and (15.3±2.5) thousand RMB) were significantly lower than those in the control group (16±2.7) d and (19.6±3.1) thousand RMB) (P<0.05) . Follow-up was conducted 8 to 12 weeks after discharge and no significant difference of postoperative complications and postoperative body weight growth of the infants between two groups was found (P > 0.05) , but the body weight of infants in ERAS group increased faster than that in control group.Conclus ion As a safe and feasible approach, ERAS in the infants with congenital duodenal obstruction can shorten the length of hospital stay and reduce hospital expenses and the incidence of complications.