加速康复外科在治疗老年胆总管结石中的应用分析
李昌1 ，蓝诺2* ，王磊1 ，韩冰1 ，杨岩1 ，王仰亮1
（山东省单县中心医院：1.肝胆外科；2.麻醉科，山东 菏泽，274300）
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摘要：
目的 探讨加速康复外科（ERAS）在腹腔镜胆总管探查取石术（LCBDE）治疗老年胆总管结石患者中的应用效果。方法 选取2015 年3 月至2017 年3 月于我院行腹腔镜探查取石术治疗的80 例老年胆总管结石患者，采用随机方法分为ERAS 组 和对照组，每组40 例。ERAS 组给予加速康复方案治疗，对照组给予常规治疗。比较两组患者手术情况、术后疼痛评分情况及 术后并发症发生率。结果 ERAS 组术后进食时间、胃肠功能恢复时间、下床活动时间、住院时间明显短于对照组，白蛋白输入 量少于对照组（P<0.05）。ERAS 组术后咽痛、腹胀、肺部感染的发生率均明显低于对照组（P<0.05），术后疼痛评分明显低于对 照组（P<0.05）。结论 加速康复治疗联合腹腔镜在老年胆总管结石患者的治疗中安全有效，可以促进老年患者的术后康复，值得推广。
关键词：胆总管结石；腹腔镜胆总管探查取石术；加速康复外科
中图分类号：R493 文献标志码：A文章编号：2096-1413(2018)06-0052-02
Application analysis of enhanced recovery after surgery in the treatment of elderly patients with choledocholithiasis
LI Chang1, LAN Nuo 2 *, WANG Lei 1, HAN Bing1, YANG Yan 1, WANG Yang-liang1
(1. Hepatological Surgery Department; 2. Anesthesia Department, Central Hospital of Shan County, Heze 274300, China)
ABSTRACT: Objective To analyze the impact of enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) on elderly patients with choledocholithiasis. Methods Eighty patients with choledocholithiasis received laparoscopic surgery in our hospital from March 2015 to March 2017 were selected, and randomly divided into control group and ERAS group, with 40 cases in each group. The control group was treated with conventional perioperative and the ERAS group was treated with ERAS. The intraoperative situation, postoperative pain score and the incidence of postoperative complications of the two groups were compared. Results The time of intake food, the recovery time of gastrointestinal function, the time of out of bed activity and the time of hospitalization in the ERAS group were significantly shorter than those of the control group (P<0.05). The amount of albumin of the ERAS group was significantly less than that of the control group (P <0.05). The incidences of sore throat, abdominal distension, lung infections of the ERAS group were significantly lower than those of the control group, and the pain score of the ERAS group was lower than that of the control group (P<0.05). Conclusion LCBDE combined with ERAS is safe and effective in treatment with the elderly choledocholithiasis, and can promote postoperative rehabilitation, which is worth to be popularized and applied.
KEYWORDS: choledocholithiasis; LCBDE; ERAS
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