胃肠道肿瘤ERAS患者术后恢复室滞留原因分析

Analysis of postoperative recovery room retention in gastrointestinal cancer patients with enhanced recovery after surgery

摘要:

目的：探讨胃肠道肿瘤加速康复外科（enhanced recovery after surgery，ERAS）患者术后在恢复室滞留的可能因素。方法：回顾性分析重庆医科大学附属第一医院胃肠外科2019年3月1日至9月30日入组ERAS的胃肠道肿瘤手术连续病例，延迟拔管组（入室后15 min以上拔管）和正常拔管组（入室后15 min内拔管，含15 min）各76例。观察2组患者性别、年龄、手术时间、最后一次镇痛给药距手术结束时间、恢复室滞留时间。结果：延迟拔管组患者年龄[（66.70±9.25）岁]明显高于正常拔管组[（53.42±17.12）岁]（P=0.000）；延迟拔管组患者手术时间[（172.93±75.31） min]明显长于正常拔管组[（147.80±70.62） min]（P=0.035）；术中最后一次镇痛给药距手术结束时间，延迟拔管组[（32.30±22.17） min]明显短于正常拔管组[（46.09±34.64） min]（P=0.004）；延迟拔管组恢复室滞留时间[（90.99±25.95） min]明显长于对照组[（66.97±15.77） min]（P=0.000）。结论：优化手术流程及加强术中麻醉管理，可降低胃肠道肿瘤ERAS患者术后恢复室滞留时间。

Abstract:

Objective：To explore the possible factor of postoperative recovery room retention in gastrointestinal cancer patients with enhanced recovery after surgery（ERAS）. Methods：Consecutive cases of gastrointestinal cancer surgery with ERAS in gastrointestinal surgery department of our hospital from March 1，2019 to September 30，2019 were retrospectively analyzed and were divided into the delayed extubation group（extubation time more than 15 minutes） and the normal extubation group（extubation time less than or equal to 15 minutes）（n=75）. The gender，age，operation time，the time of the last analgesic administration to the end of the operation，and the retention time in the recovery room in two groups were analyzed. Results：The age of patients in the delayed extubation group [（66.70±9.25） years old] was significantly higher than that in the normal extubation group[（53.42±17.12） years old]（P=0.000）. The operation time of the delayed extubation group[（172.93±75.31） min] was significantly longer than that in the normal extubation group（147.80±70.62） min]（P=0.035）. The time of the last analgesic administration to the end of the operation was significantly shorter in the delayed extubation group[（32.30±22.17） min] than that in the normal extubation group[（46.09±34.64） min]（P=0.004）. The retention time in the recovery room in the delayed extubation group[（90.99±25.95） min] was significantly longer than that in the control group[（66.97±15.77） min]（P=0.000）. Conclusion：Optimizing the surgical procedure and strengthening the man－agement of intraoperative anesthesia can reduce the postoperative recovery room retention time of gastrointestinal cancer patients with ERAS.