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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (12): 92-96.doi: 10.6040/j.issn.1671-7554.0.2020.0670

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加速康复外科理念在1~3岁日间疝手术中的应用

王波1,熊颖2,倪志福1,屈振繁1   

  1. 1. 十堰市太和医院 湖北医药学院附属医院小儿外科, 湖北 十堰 442000;2. 十堰市妇幼保健院新生儿科, 湖北 十堰 442000
  • 发布日期:2020-12-08
  • 通讯作者: 屈振繁. E-mail:346808220@qq.com

Application of ERAS in day hernia surgery for children aged 1 to 3 years

WANG Bo1, XIONG Ying2, NI Zhifu1, QU Zhenfan1   

  1. 1. Department of Pediatric Surgery, Taihe Hospital of Shiyan, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan 442000, Hubei, China;
    2. Department of Neonatology, Shiyan Maternal and Child Health Hospital, Shiyan 442000, Hubei, China
  • Published:2020-12-08

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摘要： 目的 探讨加速康复外科(ERAS)理念在1~3岁小儿外科日间疝手术中的应用效果。 方法 回顾性分析十堰市某三甲医院小儿外科自2018年7月至2019年9月期间收治的1 100例1~3岁腹股沟斜疝患儿资料,患儿均采用日间模式行腔镜疝手术治疗,按处理措施不同分为ERAS组和标准腔镜组。采用Mann-Whitney U和χ2检验分析两组基本特征分布差异,采用χ2检验和二分类Logistic回归分析比较两组术后指标差异。 结果 ERAS组(550例)和标准腔镜组(550例)在年龄、性别和体质量等方面差异无统计学意义(P>0.05),但ERAS组在饥饿评分、疼痛评分(VAS评分)、Ramsay镇静评分、术后并发症等方面显著优于标准腔镜组(P<0.01)。Logistic回归分析结果显示,标准腹腔镜组的术后并发症发生风险显著高于ERAS组(OR=4.41,95% CI为1.475~13.204)。 结论 ERAS措施在日间模式行腔镜疝手术中比标准腹腔镜治疗更有优势,值得在临床推广应用。

关键词: 加速康复外科理念, 小儿外科, 腹股沟疝, 腹腔镜下疝囊高位结扎

Abstract: Objective To explore the application of enhanced recovery after surgery(ERAS)in pediatric day hernia surgery for children aged 1 to 3 years. Methods The clinical data of 1 100 children(1-3 years old)with inguinal hernia treated with day surgery during July. 2018 and Sep. 2019 were retrospectively analyzed. The children were divided into the ERAS group(n=550)and control group(n=550). The difference in the distribution of basic characteristics were compared between the two groups with Mann-Whitney U and Chi-square test. The postoperative indexes were compared with Chi-square test and binary Logistic regression analysis. Results There were no significant differences in age, gender and weight between the two groups(P>0.05). The ERAS group was better in hunger score, VAS score, Ramsay sedation score and postoperative complications than the control group(P<0.01). Logistic regression analysis showed that the control group had significantly higher risk of postoperative complications than the ERAS group(OR=4.41, 95%CI: 1.475-13.204). Conclusion ERAS has more advantages over standardized treatment in day hernia surgery, and it is worth popularizing in clinical practice.

Key words: Enhanced recovery after surgery, Pediatric surgery, Inguinal hernia, Laparoscopic high ligation of hernia sac

中图分类号: 

  • R726
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