Résumé
Objective To explore the application effect of the concept of accelerated rehabilitation surgery in elderly patients with choledocholithiasis.Methods A total of 28 patients with choledocholithiasis were treated in Department of General Surgery,Huainan First People's Hospital of Anhui Province in recent years.According to different interventions during perioperative period,they were divided into group ERAS (n =15) and control group (n =13).In group ERAS,systematic and orderly intervention was guided by the concept of rapid rehabilitation during perioperative period,while the control group adopted traditional perioperative management plan.Postoperative anal ventilation time,first out of bed time,postoperative hospital stay,postoperative complications,postoperative leukocyte and albumin differences between the two groups were compared.Measurement data were expressed by (-x ± s).T test was used for comparison between groups.Comparison of counting data were analyzed using Fisher exct probability between groups.Results The anus ventilation time after operation in group ERAS was (37.5 ± 3.7) h,the first time to get out of bed was (14.2 ± 4.1) h,and the number of days after operation was (8.7 ± 4.6) d,while the time of anus ventilation in the control group was (46.1 ± 3.2) h,and the first time to get out of bed was (21.4 ±4.2) h,and the number of days after operation was (13.8 ±7.2) d,and the difference of two groups was statistically significant (P ＜ 0.05).In group ERAS,albumin was (34.3 ± 1.7) g/L for the first time after operation,while (29.5 ± 2.0) g/L in control group.The difference between the two groups was statistically significant (P ＜ 0.05).However,the complications and first reexamination of leukocyte in the two groups were no difference.Conclusion The application of ERAS in the operation of choledocholithiasis in elderly patients with choledocholithiasis can accelerate the anal ventilation,shorten the days of hospitalization,reduce postoperative complications,and improve the postoperative recovery.
Résumé
Objective To investigate the effects of painless ward standardized pain management on pain control and postoperative recovery of patients with inguinal hernia after surgery.Methods From January 2015 to January 2016,44 cases of inguinal hernia in Department of General Surgery,First People's Hospital of Huainan,control group (22 cases) and observation group (22 cases) were retrospectively studied.The patients in observation group underwent painless ward standardized pain management and those in control group underwent traditional pain mnanagement model.Pain score after surgery,time for get out of bed after surgery,postoperative intestinal exhaust time,duration of night sleep,and satisfaction degree for pain-control were comparrd between two groups of patients.Results For pain score after surgery,the observation group 3 h after operation,postoperative 1 d,2 d pain score respectively (3.46 ± O.56),(2.72 ± O.21),(2.20 ± O.43) points,the control group 3 h after operation,postoperative 1 d,2 d pain score respectively (4.48 ± 1.52),(3.55 ± 0.40),(2.80 ± 0.40) points,there were significant difference between two groups (P ＜ 0.05).For sleep time,the observation group on the day of surgery,postoperative 1 d,2 d sleep time respectively (5.23 ± 0.98) h,(6.57 ± 0.54) h,(7.50 ± 0.54) h,the control of sleep time of 2 d group on the day of surgery,postoperative 1 d,respectively (4.35 e 1.28) h,(5.17 ± 0.45) h,(6.72 ± 0.61) h,there were significant difference between two groups (P ＜ 0.05).The satisfaction rate of pain control in the observation group was 86.3％,which was higher than that of the control group 50.0％ (P ＜ 0.05).The observation group first ambulation time,anal ventilation time,hospital stay were (10.5 ± 2.0) h,(16.8±2.1) h,(6.6±1.4) d,the control group for the first time,ambulation time,anal ventilation time,hospital stay were (15.9 ± 3.O) h,(22.6 ± 3.3) h,(7.5 ± 1.2) d,there were significant difference between two groups (P ＜ 0.05).However,there was no difference between the two groups in the total cost of hospitalization.Conclusions Application of painless ward standardized pain management for patients with inguinal hernia after surgery can shorten time for get out of bed after surgery,postoperative intestinal exhaust time,prolong duration of night sleep,improve satisfaction degree for pain-control during hospitalization.