Effect of enhanced recovery after surgery on thyroid surgery

doi:10.16139/j.1007-9610.2020.03.015

Abstract

Abstract:

Objective To evaluate the effects of enhanced recovery after surgery (ERAS) for thyroid surgery throughout the perioperative period. Methods A total of 120 cases with thyroid surgery in our hospital from March to June 2018 were divided into ERAS group and traditional group with 60 cases each. Pain scores after surgery, postoperative complications, length of hospital stay and costs were compared between two groups. Results The pain scores (2.2 vs. 2.8), length of hospital stay (1.0 d vs. 3.4 d) and costs (10 204.8 Yuan vs. 12 449.2 Yuan) in ERAS group were less than those in traditional group (P<0.001). There was no statistical difference in postoperative complications rate between two groups. Conclusions It could be found that ERAS helped to decrease length of hospital stay and reduce cost while improve postoperative pain control.

Key words: Enhanced recovery after surgery, Thyroid disease, Surgery

CLC Number:

R653

ZHENG Lei, ZHANG Shiyu, YAN Jiqi. Effect of enhanced recovery after surgery on thyroid surgery[J]. Journal of Surgery Concepts & Practice, 2020, 25(03): 252-255.

Figures/Tables 3

References 12

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围术期	ERAS组	传统组
术前	术前8 h禁高脂餐,6 h禁清淡饮食,2 h禁饮	术前晚8点禁食,10点禁水
	术晨给予流质饮食或口服葡萄糖液	术晨静脉点滴5%GS、5%GNS 500~1 000 mL
	ERAS理念指导下的健康教育	常规健康教育
	常规术前检查	常规术前检查外,加行喉镜检查
术中	减少液体治疗量,静滴补充入量控制在1 000 mL以内	不特殊控制液体治疗量
术后	术后2 h下床活动	术后6 h下床活动
	术后2 h进食	术后6 h进食
	疼痛评估,必要时用药	疼痛评估
	静脉补钙5%GS 500 mL+葡萄糖酸钙1 g,口服钙片,每天1片（含钙600 mg）	静脉补钙5%GS 500 mL+葡萄糖酸钙1 g,口服钙片,每天1片（含钙600 mg）
出院	术后1个月医院复查	术后1、3、7 d电话随访,术后1个月医院复查

项目		总体（n=120）	ERAS组（n=60）	传统组（n=60）	t	χ²	P
年龄（岁）		40.3±10.8	40.6±11.5	40.0±10.1	0.312		0.755
性别	男	33（27.5）	15（25）	18（30）		0.376	0.540
	女	87（72.5）	45（75）	42（70）
手术时间（min）		127.2±35.3	122.5±32.1	131.8±37.8	1.444		0.151
肿瘤性质	甲状腺乳头状癌	87（72.5）	41（68.3）	46（76.7）		2.327	0.312
	甲状腺滤泡状腺癌	8（6.7）	6（10.0）	2（3.3）
	结节性甲状腺肿	25（20.8）	13（21.7）	12（20.0）
手术方式	甲状腺单侧腺叶切除+颈部淋巴结清扫术	74（61.7）	37（61.7）	37（61.7）		0.448	0.930
	甲状腺全切除术+颈部淋巴结清扫术	21（17.5）	10（16.7）	11（18.3）
	甲状腺单侧腺叶切除术	20（16.7）	11（18.3）	9（15.0）
	甲状腺全切除术	5（4.2）	2（3.3）	3（5.0）
吸烟史	有	10（8.3）	3（5.0）	7（11.7）		1.745	0.186
	无	110（91.7）	57（95.0）	53（88.3）

项目	ERAS组（n=60）	传统组（n=60）	t	χ²	P
VAS评分（分）	2.2±0.6	2.8±0.4	6.950		<0.001^a)
住院时间（d）	1.0±0.2	3.4±1.1	17.034		<0.001^a)
住院费用（元）	10 204.8±2 118.7	12 449.2±2 088.3	5.844		<0.001^a)
并发症（%）	17（28.3）	9（15.0）		3.142	0.076
手足麻木	8（13.3）	3（5.0）		2.502	0.114
恶心呕吐	2（3.3）	0		2.034	0.154
声音嘶哑	12（20.0）	6（10.0）		2.353	0.125

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