加速康复外科理念在老年局部进展期肾癌病人围手术期中的应用

doi:10.3969/j.issn.1005-6483.2021.04.023

摘要/Abstract

摘要： 目的：探讨加速康复外科(ERAS)在老年局部进展期肾癌(RCC)病人围手术期中的应用效果。方法：将2015年6月~2020年6月期间收治的100例局部进展期RCC病人随机分为对照组(n=50)和ERAS组(n=50)。对照组采用常规护理，ERAS组在常规护理基础上执行ERAS相关措施。观察术后首次排气、排便时间、术后第5天的疼痛程度(VAS)、C反应蛋白(CRP)水平、住院时间、并发症、再入院情况(出院30d内)及护理满意度调查。结果：与对照组相比，ERAS组术后首次排气时间、排便时间、住院时间均显著缩短(P＜0.05)；而术后VAS评分、CRP水平和术后30d再入院率，对照组与ERAS组比较，差异无统计学意义(P＞0.05)；对照组病人并发症发生率要显著高于ERAS组(P＜0.05)；ERAS组病人护理满意度显著高于对照组(P＜0.05)。结论：ERAS能够促进老年局部进展期RCC病人的术后康复，减少并发症，提高护理满意度。

关键词: 加速康复外科, 局部进展期肾癌, 老年病人, 围手术期

Abstract: Objective：To explore the effect of enhanced recovery after surgery(ERAS) in perioperative period of elderly patients with locally advanced renal cell carcinoma(RCC).Methods：100 patients with locally advanced renal carcinoma admitted from June 2015 to June 2020 were randomly divided into control group(n=50) and ERAS group(n=50).The patients in the control group were given routine nursing during the perioperative period,and ERAS group was given measures related to ERAS on the basis of routine nursing.Postoperative first exhaust time,first defecation time,length of hospital stay,incidence of complications,readmission rate(within 30 days after discharge),nursing satisfaction,as well as pain degree and Creactive protein(CRP) level at 5 days after surgery were monitored in the two groups.Results：There were no statistically significant differences between the two groups in general conditions,operation time and intraoperative blood loss(P>0.05).ERAS group had significantly shorter postoperative exhaust time,first defecation time and hospital stay time than the control group(P＜0.01).There were no significant differences between the control group and ERAS group(P>0.05) in postoperative VAS score,CRP level and readmission rate 30 days after surgery.The complication rate of patients in the control group was significantly higher than that of ERAS group(P＜0.05),and the nursing satisfaction of patients in ERAS group was significantly higher than that of the control group(P＜0.05).Conclusion：ERAS in the perioperative period of elderly patients with locally advanced RCC can effectively promote postoperative rehabilitation of patients,reduce the incidence of complications and improve patient satisfaction.

Key words: enhanced recovery after Surgery, locally advanced renal cell carcinoma, elderly patients, perioperative period

李晓燕, 罗翠, 王婷等. 加速康复外科理念在老年局部进展期肾癌病人围手术期中的应用[J]. 临床外科杂志, 2021, 29(4): 379-381.

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