在儿科腹腔镜袖子胃切除术中利用手术后增强恢复 (ERAS) 协议:质量改进项目
Fari Fall1,2, Devon Pace1,2, Julia Brothers3
1Department of Surgery, Nemours Children's Health, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Pediatric surgery international
|November 7, 2024
概括
对接受减肥手术的青少年实施手术后增强恢复 (ERAS) 协议,可显著加快口服摄入量并减少住院时间. 这种方法对儿科代谢和减肥手术 (MBS) 患者是安全有效的.
科学领域:
- 青少年手术 青少年手术
- 腹腔外科手术是什么意思
- 手术后增强恢复 (ERAS) 协议.
背景情况:
- 青少年肥胖率的上升需要增加代谢和减肥手术 (MBS).
- 关于综合性手术后复原 (ERAS) 协议在这种儿科患者群体的影响的数据有限.
研究的目的:
- 评估综合ERAS途径对接受腹腔镜袖胃切除术 (LSG) 的青少年的有效性.
- 评估ERAS对关键结果的影响,包括阿片类药物使用,抗要求,口服摄入量和住院时间 (HLOS).
主要方法:
- 对接受LSG的青少年实施一个减肥特异性的ERAS途径.
- 关键要素包括碳水化合物负载,多式联络止痛,区域麻醉和早期出行.
- 测量结果:阿片类药物的使用,救援抗使用,口服时间,HLOS,疼痛评分和系统回报.
主要成果:
- 后ERAS组显示显著更早的时间口服 (3.0对5.5小时) 和更短的HLOS (33对54小时).
- 在ERAS后的组中,观察到对救援抗药物的需求减少.
- 在阿片类药物使用,术后疼痛或患者返回系统方面没有发现显著差异.
结论:
- 一个减肥特异性的ERAS协议,包括手术内输注利多卡因,有效地加速口服摄入量,并减少接受LSG的青少年的HLOS.
- 将成人ERAS协议适应儿科MBS群体是可行的和有益的.
- ERAS途径改善了恢复,但没有增加不良事件或再录取.
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