%0 Journal Article %T 基于加速康复外科理念行日间腹腔镜阑尾切除术的临床疗效观察 %T Observation of clinical efficacy of day-time laparoscopic appendectomy based on enhanced recovery after surgery %A 刘如锋,徐景聪,何凤连 %A LIU,Ru feng %A XU,Jing cong %A HE,Feng lian %J 中国临床新医学 %J CHINESE JOURNAL OF NEW CLINICAL MEDICINE %@ 1674-3806 %V 13 %N 4 %D 2020 %P 397-400 %K 日间腹腔镜阑尾切除术;加速康复外科理念;C反应蛋白;并发症 %K Day-time laparoscopic appendectomy;Enhanced recovery after surgery(ERAS);C-reactive protein(CRP);Complications %X [摘要] 目的 观察基于加速康复外科理念(enhanced recovery after surgery,ERAS)行日间腹腔镜阑尾切除术的临床疗效。方法 选取2018-02~2019-10在该院行日间腹腔镜阑尾切除术治疗的90例急性阑尾炎患者,按随机数字表法分为观察组和对照组,每组45例。观察组行基于ERAS理念行围术期处理,对照组行常规围术期处理。比较两组术后首次下床活动时间、肛门排气时间、住院时间、术后6 h疼痛程度、并发症发生情况及术前、术后1 d时血浆C反应蛋白(C-reactive protein,CRP)水平。结果 观察组术后疼痛程度评分低于对照组,术后首次下床活动时间、肛门排气时间、住院时间短于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为2.22%,低于对照组的17.78%,差异有统计学意义(P<0.05)。观察组术前血浆CRP水平与对照组比较,差异无统计学意义(P>0.05),术后1 d两组血浆CRP水平较术前明显增高,但观察组血浆CRP水平低于对照组,差异有统计学意义(P<0.05)。结论 基于ERAS理念行日间腹腔镜阑尾切除术中围术期处理能减轻手术创伤,减轻术后疼痛程度及炎症反应,减少并发症发生,缩短术后恢复时间,值得临床推广。 %X [Abstract] Objective To observe the clinical efficacy of day-time laparoscopic appendectomy based on enhanced recovery after surgery(ERAS). Methods Ninety patients with acute appendicitis who underwent day-time laparoscopic appendectomy in our hospital from February 2018 to October 2019 were selected and divided into observation group and control group according to the random number table method, with 45 cases in each group. The observation group received perioperative treatment based on ERAS, and the control group received routine perioperative treatment. The first leaving bed time after operation, the postoperative exhausting time, the length of hospital stay, the degree of pain 6 hours after operation, the incidence of postoperative complications and the levels of plasma C-reactive protein(CRP) before and 1 day after operation were compared between the two groups. Results The postoperative pain scores of the observation group were lower than those of the control group. The first leaving bed time after operation, the postoperative exhausting time, the length of hospital stay in the observation group were significantly shorter than those in the control group(P<0.05). The incidence of postoperative complications in the observation group(2.22%) was significantly lower than that in the control group(17.78%)(P<0.05). There was no significant difference in the level of plasma CRP between the two groups before operation(P>0.05). Compared with those before operation, the levels of plasma CRP in the two groups were significantly higher 1 day after operation, but the level of plasma CRP in the observation group was significantly lower than that in the control group(P<0.05). Conclusion The day-time laparoscopic appendectomy based on ERAS can reduce surgical trauma, inflammatory response and complications, relieve postoperative pain, and shorten the postoperative recovery time, which is worthy of clinical promotion. %R 10.3969/j.issn.1674-3806.2020.04.20 %U http://www.zglcxyxzz.com/ch/reader/view_abstract.aspx %1 JIS Version 3.0.0