| 摘要: |
| 目的:研究中医结合加速康复外科方法在急诊腹腔镜胆囊切除联合胆管切开取石术患者中临床应用效果。方法:选取2022年1月—2024年6月我院收治的120例急诊行腹腔镜下胆囊切除并胆总管探查术(LCBDE)的患者作为研究对象，按照康复方法分为中医结合加速康复外科方法(CMERAS)组与加速康复外科方法(ERAS)组两组，每组各60例。回顾性分析两组的炎症因子水平、临床相关指标、胃肠功能指标、疼痛评分及术后并发症情况。结果:在炎症因子、肝功能指标、应激因子水平、胃肠功能指标方面，术后3 d，CMERAS组均优于ERAS组，差异有统计学意义(P ＜0.05)，但术后5 d两组均无明显差异(P ＞0.05)；并发症方面，CMERAS组总并发症发生率低于ERAS组，差异有统计学意义(P ＜0.05)；术后疼痛评分方面，CMERAS组疼痛评分低于ERAS组，差异有统计学意义(P ＜0.05)。术后72 h，两组疼痛评分无明显差异(P ＞0.05)。结论:CMERAS应用于急诊LCBDE可减轻患者围术期产生的应激反应，加快患者术后康复，缩短住院时间。 |
| 关键词: 腹腔镜胆囊切除胆总管探查术 中医结合加速康复外科方法 应激反应 |
| DOI：10.3969/j.issn.1007-6948.2025.05.009 |
| 投稿时间：2024-08-07 |
| 基金项目:上海市卫生健康系统重点扶持学科-康复医学(2023ZDFC0301) |
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| Clinical application of emergency laparoscopic cholecystectomy combined with choledocholithotomy using CMERAS concept |
| XU Wen-jie,ZHAO Lian-ze,BAO Ji-feng |
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| Abstract: |
| Objective To explore the clinical application of Chinese Medicine Enhanced Recovery After Surgery (CMERAS) in patients undergoing emergency laparoscopic cholecystectomy combined with choledocholithotomy. Methods A total of 120 patients who underwent emergency laparoscopic cholecystectomy and common bile duct exploration (LCBDE) in our hospital from January 2022 to June 2024 were selected as the research subjects. They were divided into the CMERAS group and the Enhanced Recovery After Surgery (ERAS) group according to the rehabilitation methods, with 60 cases in each group. A retrospective analysis was conducted on the levels of inflammatory factors, clinically relevant indicators, gastrointestinal function indicators, pain scores and postoperative complications of the two groups. Results In terms of inflammatory factors, liver function indicators, stress factor levels and gastrointestinal function indicators, the CMERAS group was superior to the ERAS group at 3 days after surgery, and there were significant differences between the two groups (P <0.05). However, there were no significant differences between the two groups at 5 days after surgery (P >0.05). In terms of complications, the total complication incidence rate in the CMERAS group was lower than that in the ERAS group, with a significant difference (P <0.05). In terms of postoperative pain scores, the pain scores in the CMERAS group were lower than those in the ERAS group, with a significant difference (P <0.05). There were no significant differences between the two groups at 72 hours after surgery (P >0.05). Conclusion The application of CMERAS in emergency LCBDE can reduce the stress response generated during the perioperative period of patients, accelerate the postoperative rehabilitation of patients and shorten the length of hospital stay. |
| Key words: Laparoscopic cholecystectomy and common bile duct exploration Chinese Medicine Enhanced Recovery After Surgery stress response |
