[1]孙瑞方,吴兰兰,刘 瑶,等.加速康复外科围手术期营养管理对儿童耳鼻喉外科病人临床结局的影响[J].肠外与肠内营养杂志,2022,(06):342-346.[doi:10.16151/j.1007-810x.2022.06.004]
　SUN Rui-fang,WU Lan-lan,LIU Yao,et al.Effect of perioperative nutrition management of enhanced recovery after surgery on clinical outcome in children undergoing otolaryngology surgery[J].PARENTERAL & ENTERAL NUTRITION,2022,(06):342-346.[doi:10.16151/j.1007-810x.2022.06.004]
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加速康复外科围手术期营养管理对儿童耳鼻喉外科病人临床结局的影响
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2022年06期
页码:
342-346
栏目:
论著
出版日期:
2022-11-10

文章信息/Info

Title:
Effect of perioperative nutrition management of enhanced recovery after surgery on clinical outcome in children undergoing otolaryngology surgery
作者:
孙瑞方; 吴兰兰; 刘 瑶; 韦远欢; 沈思文; 王诺亚; 简西廷; 邓桂芳
华中科技大学协和深圳医院临床营养科，广东深圳 518052
Author(s):
SUN Rui-fang;  WU Lan-lan;  LIU Yao;  WEI Yuan-huan;  SHEN Si-wen;  WANG Nuo-ya;  JIAN Xi-ting;  DENG Gui-fang
Department of clinical nutrition, Union Shenzhen Hospital of Huazhong University of Science and Technology CN, Shenzhen 518052, Guangdong, China
关键词:
加速康复外科 ; 儿童耳鼻喉外科 ; 围手术期营养管理 ; 临床结局
Keywords:
Enhanced recovery after surgery;  Otolaryngology surgery for children;  Perioperative nutritional management;  Clinical outcome
分类号:
R459.3
DOI:
10.16151/j.1007-810x.2022.06.004
文献标志码:
A
摘要:
目的：探讨加速康复外科围手术期（ERAS）营养管理对儿童耳鼻喉外科病人临床结局的影响。 方法：采用前瞻性队列研究设计，纳入2017年1月至2021年8月就诊于华中科技大学协和深圳医院耳鼻喉外科行手术的儿童病人，根据病儿及家属意愿分为常规组和ERAS组。以出院结算为终点，使用SPSS 24.0进行倾向性评分匹配，采用独立样本t检验、χ2检验分析ERAS营养管理对儿童耳鼻喉外科病人手术经济效应和术后并发症发生率的影响。 结果：最终纳入820人，常规组483人，ERAS组337人，进行1：1倾向性评分匹配后，两组各240人。倾向性匹配后，与常规组相比，ERAS组住院总天数（天）、术后住院天数（天）、围手术期总补液量（mL）、围手术期每公斤体重补液量（mL/kg）、围手术期滴注用药费用（元）、抗生素费用（元）均明显较少，且差异有统计学意义（P均<0.05）。住院总费用（元）和对照组相比差异无统计学意义。并发症方面，与对照组相比，ERAS组病人发热发生率明显降低，且有统计学意义（P < 0.05）。呕吐、出血、脓性分泌物、创面污秽、头疼、咳嗽、咳痰等发生率两组差异无统计学意义，ERAS组和常规组相比总并发症发生率明显减少，差异有统计学意义（P < 0.05）。 结论：对耳鼻喉外科的儿童实施加速康复外科围手术期营养管理可以缩短病儿的住院时间，减少抗生素的费用及围手术期补液量，减少发热并发症的发生，更利于病儿的康复。
Abstract:
Objective: To explore the effect of perioperative nutrition management of enhanced recovery after surgery(ERAS) on the clinical outcome in children undergoing otolaryngology surgery. Methods: This prospective cohort study was conducted in Union Shenzhen Hospital of Huazhong University of Science and Technology CN from January 2017 to August 2021. This study recruited children who underwent otolaryngology surgery, and the end point was discharge settlement. Subjects were divided into the control group and the ERAS group according to patients' preference. After propensity score matching, the effect of perioperative ERAS nutritional management on the cost effectiveness and postoperative complications in pediatric patients undergoing otorhinolaryngological surgery. Data was analyzed by independent sample t-test and chi square test using SPSS 24.0. Results: A total of 820 patients (483 in control group and 337 in ERAS group) were finally included. After 1:1 propensity score matching, 240 subjects were included in each group. Compared with the control group, ERAS group showed better outcomes in the total length of hospital stay (days), postoperative length of hospital stay (days), total perioperative rehydration volume (mL), rehydration volume per kilogram of body weight (mL/kg), perioperative drip medication cost (yuan), and antibiotic cost (yuan) (all P < 0.05). There was no significant difference in the total hospitalization cost (yuan) between the two groups. Compared with the control group, ERAS group had a significantly decreased incidence of fever (P < 0.05). Incidence of vomiting, bleeding, purulent secretion, wound dirt, headache, cough and expectoration between the two groups was similar between two groups. The incidence of total complications in the ERAS group was significantly lower than that in the control group (P < 0.05). Conclusion: The implementation of perioperative ERAS nutritional management for children undergping otolaryngology surgery result in approved outcomes including shorter hospital stay, reduced cost of antibiotics and perioperative fluid replacement, and decreased incidence of fever complications, suggesting that ERAS nutritional management is benefit to the postoperative rehabilitation inchildren.

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备注/Memo

备注/Memo:
作者简介 ：孙瑞方，主治医师，医学硕士，主要从外科营养的基础和临床研究。E-mail：rfsunxf@163.com 通讯作者 ：邓桂芳，E-mail：misyfly@163.com
更新日期/Last Update: 1900-01-01