| 摘要: |
| 目的:探讨加速康复外科理念(ERAS)在脊柱骨折围手术期中的应用。方法:选取天津市天津医院脊柱外科收治的100例接受脊柱手术治疗脊柱骨折的患者，其中50例接受ERAS计划的患者为ERAS组，50例在实施ERAS计划之前接受手术的回顾性队列患者为对照组，比较两组患者术后疼痛评分(VAS评分)、阿片类药物消耗量、住院时间、术后30 d并发症和30 d再住院率。结果: ERAS组术后VAS评分为术后第1天(6.80±1.90)分，第2天(6.50±2.10)分，第3天(5.80±1.60)分，出院时(3.80±1.10)分和术后1个月(3.20±1.30)分均低于对照组，差异有统计学意义(P<0.05)；术前，ERAS组与对照组阿片类药物消耗量差异无统计学意义(P>0.05)，ERAS组阿片类药物消耗量术后第1天(12.50±3.90)片，第2天(10.50±3.70)片，第3天(8.70±3.10)片均低于对照组，差异有统计学意义(P<0.05)；ERAS组平均住院时间为(3.90±1.62) d小于对照组(7.14±3.45) d，差异有统计学意义(P<0.05)；术后30 d并发症发生率，对照组(30%)高于ERAS组(12%)，差异有统计学意义(P=0.03)；两组30 d再住院率差异无统计学意义(P=0.37)。结论: ERAS可显著加快脊柱骨折患者术后恢复，让更多的脊柱外科患者受益，值得推广应用。 |
| 关键词: 加速康复外科 脊柱手术 住院时间 术后疼痛 阿片类药物消耗 |
| DOI：10.3969/j.issn.1007-6948.2021.05.011 |
| 投稿时间：2021-03-25 |
| 基金项目:国自然基金(81871777)；天津市中医药重点领域科技项目(2017008)；天津市卫健委基金,科技人才培育项目(RC20204)；天津市骨科研究所基金(2019TJGYSKY03) |
|
| Application of Enhanced Recovery after Surgery (ERAS) in Perioperative Treatment of Spinal Fracture |
| TIAN Ai-xian,MA Jian-xiong,MA Xin-long |
| Institute of Orthopedics, Tianjin Hospital Tianjin Hospital, Tianjin University,Tianjin 300050, China |
| Abstract: |
| Objective To explore the application of enhanced recovery after surgery (ERAS) in the perioperative period of spinal fractures. Methods In this study, 50 patients admitted to the spine surgery department of Tianjin Hospital who underwent ERAS program were assigned to the ERASgroup, and 50 retrospective cohort patients who underwent surgery before the implementation of ERAS program were assigned to the control group.Postoperative pain score (VAS score), opioid consumption, length of hospital stay, postoperative complications and 30-day rehospitalization rate were compared between the two groups. Results Postoperative VAS scores of ERAS group were (6.80±1.90), (6.50±2.10), (5.80±1.60), (3.80±1.10) at discharge and (3.20±1.30) one month after operation, all of which were lower than those of control group (P<0.05).Before surgery, there was no significant difference in the consumption of opiates between ERAS group and control group (P>0.05). The consumption of opiates in ERAS group on day 1, day 2 and day 3 were all lower than those in control group (12.50±3.90), (10.50±3.70) and (8.70±3.10), with statistical significance (P<0.05). The average length of hospital stay in ERAS group was (3.90±1.62) days less than that in control group (7.14±3.45) days, and the difference was statistically significant (P<0.05).Complications at 30 days after surgery were significantly higher in the control group (15 cases) (30%) than in the ERAS group (6 cases) (12%) (P=0.03).There was no significant difference in the 30-day rehospitalizationrate between the two groups (P=0.37). Conclusion ERAS can significantly accelerate postoperative recovery of patients with spinal fractures and bene?t more patients with spinal surgery, so it is worth promoting. |
| Key words: Enhanced recovery spine surgery length of stay postoperative pain opioid consumption |
