Qi Jinlian,Jia Yingping,Zhang Xianwei,et al.Application of enhanced recovery after surgery in perioperative treatment of pediatric dislocation of hip joint[J].Journal of Clinical Pediatric Surgery,2021,20(10):962-967.[doi:10.12260/lcxewkzz.2021.10.013]
加速康复外科技术在小儿发育性髋关节脱位围手术期应用的研究
- Title:
- Application of enhanced recovery after surgery in perioperative treatment of pediatric dislocation of hip joint
- Keywords:
- Enhanced Recovery After Surgery; Hip Dislocation/SU; Hip Joint; Perioperative Period; Child
- 分类号:
- R726.8;R681.6
- 摘要:
- 目的 研究加速康复外科（enhanced recovery after surgery，ERAS）技术在小儿发育性髋关节脱位（developmental dislocation of the hip，DDH）围手术期的应用价值。方法 选取2017年5月至2019年5月在河南省儿童医院行DDH矫形术的76例DDH患者作为研究对象，依据电脑随机计数法，将其分为两组，即加速康复组（ERAS组）和传统方法治疗组（对照组），每组各38例。比较ERAS组和对照组的一般资料，并采用Wong Banker面部表情量表法（FPS-R）、镇痛评分（CRIES）和镇静评分（Ramsay）对术后6 h、12 h、24 h的镇痛质量进行评价。同时检测不同时间点的血浆肿瘤坏死因子-α（TNA-α）和白介素-6（IL-6），并统计分析治疗后不良反应的发生率。结果 ERAS组不同时间点的FPS-R评分和CRIES评分均低于对照组（P<0.05），Ramsay评分均高于对照组（P<0.05）；ERAS组各时间点血浆TNA-α和IL-6水平均较对照组低（P<0.05）；在不良反应发生率方面，ERAS组和对照组分别为2.63%、15.78%（P<0.05）。结论 加速康复外科技术在小儿发育性髋关节脱位围手术期应用，安全、有效、可行，可显著减少手术后炎性反应及相关并发症的发生。
- Abstract:
- Objective To explore the clinical values of enhanced recovery after surgery (ERAS) during perioperative period of pediatric developmental dislocation of the hip (DDH).Methods Between May 2017 and May 2019, 76 children undergoing DDH correction were enrolled.They were randomly assigned into two groups of ERAS and control (n=38 each).Control group received regular perioperative treatment while ERAS group underwent enhanced recovery after surgery.General profiles (including gender, age, weight, operative duration & blood loss, etc.), Wong Banker Facial Expressions Scale-Revised (FPS-R), pain score (CRIES) and sedation score (Ramsay) at postoperative 6/12/24 h were recorded in both groups.At the same time, radial arterial blood samples were taken at different postoperative timepoints to detect the plasma concentrations of tumor necrosis factor alpha (TNA-alpha) and interleukin 6 (IL-6).Then the incidence of adverse reactions was recorded after treatment.Results FPS-R and CRIES scores were lower in ERAS group than those in control group (P<0.05).Ramsay scores at different timepoints after treatment were higher in ERAS group than those in control group (P<0.05).After treatment, the levels of TNA-alpha and IL-6 at all timepoints were lower in ERAS group than those in control group (P<0.05).Regarding the incidence of adverse reactions, ERAS and control groups were 2.63% and 15.78% respectively and ERAS group was lower than control group (P<0.05).Conclusion ERAS is both safe and reliable during DDH operations.It can markedly reduce the production of inflammatory factors and related occurrence of complications.
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备注/Memo
收稿日期:2021-03-08。
基金项目:河南省医学科技攻关计划（编号：2018020689、LHGJ20190956）
通讯作者:贾英萍,Email:jayingping@sohu.com