Enhanced recovery after laparoscopic cholecystectomy in perioperative management

doi:10.16139/j.1007-9610.2020.05.017

Abstract

CLC Number:

R657.4

ZHANG Yong, SUI Meili, CUI Weidong, ZHAO Su, LI Xiaoyong, CHEN Yanjun. Enhanced recovery after laparoscopic cholecystectomy in perioperative management[J]. Journal of Surgery Concepts & Practice, 2020, 25(05): 437-439.

Figures/Tables 5

References 13

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组别	例数	年龄（岁）	性别（n）		疾病类型（n）
组别	例数	年龄（岁）	男	女	胆囊结石	胆囊息肉	两者兼有
研究组	36	44.53±10.44	18	18	10	16	10
对照组	36	44.75±9.12	16	20	12	15	9
χ²/t值		0.10		0.22			0.27
P值		0.92		0.64			0.88

组别	术前咨询与宣教	术前禁食进水处理	术前置胃管及导尿管	术中保温	术后引流管	术后镇痛措施	补液量控制	术后活动	术后饮水、进食
研究组	向病人详细解释手术方式、麻醉方式,解答病人的疑问,心理安抚,减轻术前的心理应激状态	术前禁食6 h,禁水2 h,饮300 mL含12.5%糖水	不放置	提升手术室温度,给病人提供保温毯	不放置	使用镇痛泵+口服非甾体类抗炎药物	按需控制补液量输入	根据医师评估后,只要病情允许尽早下地活动	术后6 h即允许病人饮少量水
对照组	常规术前宣教	术前晚20时后禁食,22时后禁水	常规放置	常规温度	常规放置	根据病人情况对症处理	常规补液处理	待病人一般状况好,自我意愿强烈时下床活动	排气后,病人愿意进食时开始流质

组别	例数	下床时间（h）	进食时间（h）	排气时间（h）	住院时间（d）	住院费用（元）	并发症[n(%)]
研究组	36	9.28±2.19	13.72±4.18	18.81±3.06	3.97±0.77	8 345.50±789.90	3（8.33）
对照组	36	17.27±2.17	28.00±4.32	27.28±4.37	5.47±0.77	9 688.00±868.63	8（22.22）
χ²/t值		15.68	14.25	9.53	8.22	6.86	1.53
P值		<0.05	<0.05	<0.05	<0.05	<0.05	>0.05

组别	例数	C反应蛋白（mg/L）	IL-6（ng/L）	皮质醇（nmol/L）
研究组	36	4.79±1.27	19.26±7.06	459.65±20.63
对照组	36	4.93±1.29	19.79±7.45	461.36±21.62
t值		0.45	0.31	0.34
P值		0.65	0.76	0.73

组别	例数	C反应蛋白（mg/L）	IL-6（ng/L）	皮质醇（nmol/L）
研究组	36	53.40±9.94	67.53±9.01	17.75±3.56
对照组	36	122.80±13.75	105.84±13.64	93.08±12.20
t值		24.54	14.07	35.55
P值		<0.05	<0.05	<0.05

Enhanced recovery after laparoscopic cholecystectomy in perioperative management

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