文章摘要
柴维,吴松,张新亚,张亚军,张浩鹏,刘振,贾玉强.加速康复外科方案在老年患者行腹腔镜胆总管切开取石术中的治疗效果分析[J].中国临床保健杂志,2020,23(4):527-531.
加速康复外科方案在老年患者行腹腔镜胆总管切开取石术中的治疗效果分析
Therapeutic effect of enhanced recovery after surgery in elderly patients who underwent laparoscopic cholangiotomy
投稿时间:2020-02-10  
DOI:10.3969/J.issn.1672-6790.2020.04.022
中文关键词: 胆总管结石病  腹腔镜检查  康复  生活质量
英文关键词: Choledocholithiasis  Laparoscopy  Rehabilitation  Quality of life
基金项目:
作者单位E-mail
柴维 安徽太和县人民医院肝胆外科,阜阳 236600 xinyazhangth@163.com 
吴松 安徽太和县人民医院肝胆外科,阜阳 236600 xinyazhangth@163.com 
张新亚 安徽太和县人民医院肝胆外科,阜阳 236600 xinyazhangth@163.com 
张亚军 安徽太和县人民医院肝胆外科,阜阳 236600 xinyazhangth@163.com 
张浩鹏 安徽太和县人民医院肝胆外科,阜阳 236600 xinyazhangth@163.com 
刘振 中国科学技术大学附属第一医院 安徽省立医院 普外科 xinyazhangth@163.com 
贾玉强 安徽太和县人民医院肝胆外科,阜阳 236600 xinyazhangth@163.com 
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中文摘要:
      目的 探讨加速康复外科方案在腹腔镜治疗老年胆囊结石合并胆总管结石患者的临床疗效及安全性。方法 回顾性分析2016—2018年在太和县人民医院接受腹腔镜治疗的86例胆囊结石合并胆总管结石老年患者根据是否实行加速康复外科分为加速康复外科治疗组(ERAS组)和对照组,比较两组老年患者的安全性及术后并发症情况。结果 纳入86例研究对象中,ERAS组及和对照组老年患者各43例,两组老年患者基线资料之间具有可比性。ERAS组的出血量明显少于对照组(P<0.05)。ERAS组术后总输液量、排气时间、下床时间,住院天数及住院费用明显少于对照组(P<0.05),而术后1周日常生活活动能力评分明显高于对照组(P<0.05)。ERAS组术后恶心呕吐、腹胀及疼痛的比例低于对照组(P<0.05)。ERAS组术后丙氨酸氨基转移酶(ALT)下降幅度高于对照组,白蛋白降低幅度低于对照组。结论 加速康复外科方案能提高老年患者在腹腔镜胆囊切除联合胆总管探查取石术围手术期的恢复,提高术后生活质量。
英文摘要:
      Objective To explore the clinical efficacy and safety of enhanced recovery after surgery of laparoscopic choledocholithotomy in elderly patients with cholecystolithiasis combined with choledocholithiasis.Methods A total of 86 elderly patients with cholecystolithiasis complicated with choledocholithiasis who underwent laparoscopic choledocholithiasis in Taihe people's hospital from 2016 to 2019 were randomly divided into enhanced recovery after surgery group and control group,the safety and postoperative complications of the two groups were compared.Results Among the 86 subjects,43 cases in the ERAS group and 43 cases in the control group.Baseline data of the two groups were comparable.The average blood loss in the ERAS group were significantly less than those in the control group.The total postoperative infusion volume,postoperative exhaust time,the leaving bed time,days stay in hospital and hospitalization cost of the ERAS group were significantly lower than those of the control group,while the postoperative life quality score at 1 week was significantly higher than that of the control group.The proportion of nausea,vomiting,bloating and pain in the ERAS group was lower than that in the control group.The decrease of ALT in the ERAS group was higher than that in the control group,and the decrease of albumin was lower than that in the control group.Conclusion Enhanced recovery after surgery can improve the perioperative recovery of elderly patients after laparoscopic cholecystectomy combined with common bile duct exploration and lithotomy,and improve the postoperative quality of life.
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