Clinical Study Of ERAS In Laparoscopic Surgery For Gynecological Malignant Tumors

Objective:Based on the consensus of accelerated rehabilitation surgery experts,the surgical pathway of accelerated rehabilitation for patients with gynecological malignant tumors in the perioperative period was initially constructed to meet the clinical needs,and clinical verification was conducted to provide reference for the improvement of overall clinical quality and the recovery of patients’ prognosis.Methods:Choice in March 2019 to January 2020 in women tumor of hospital of Guang Xi medical university affiliated tumor hospital met inclusion exclusion criteria of perioperative patients with gynecological malignant tumor,220 as the research object,according to admission time grouping,in March 2019 to August 2019 in hospital traditional perioperative measures of 110 patients as control group,the collection between September 2019 and January 2020 in hospital to implement rapid rehabilitation surgery concept line of laparoscopic surgery for the experimental group,110 patients,respectively,comparing the experimental group and control group in patients with postoperative distance after the anesthetic exhaust time,defecation time,for the first time The first time out of bed activity,the incidence of postoperative complications and postoperative pain score.Results : The first postoperative exhaust time,defecation time,the first time of getting out of bed,postoperative nausea,and the incidence of lower limb venous thrombosis were 21.43±10.97 h,48.13±19.69 h,49.55±18.34 h,15.0%,and 0.0%,respectively,in the experimental group,compared with the control group(27.55±12.92 h,56.95±18.60 h,58.23±17.57 h,35.0%,and 2.5%).The differences were statistically significant(P < 0.05).Compared with the control group,the NRS score of the experimental group significantly decreased at 12 h and 24 h after operation(P < 0.05).There was no statistically significant difference between the two groups in NRS score and incidence of postoperative fever at 48h(P >0.05).The first time of postoperative exhaust,defecation,first time of getting out of bed and incidence of postoperative nausea in the experimental group were20.00±8.43 h,45.15±17.41 h,41.50±19.28 h and 10%,respectively,compared with the control group(24.68±11.44 h,53.43±18.40 h,50.53±18.05 h,25.0%).The differences were statistically significant(P < 0.05).Compared with the control group,the NRS score of the experimental group significantly decreased at 12 h and 24 h after operation(P < 0.05).There was no statistically significant difference in NRS score,postoperative fever and incidence of venous thrombosis between the two groups at 48h(P > 0.05).The first postoperative exhaust time,defecation time and the first time of getting out of bed were24.08±10.92 h,49.70±18.51 h and 46.30±18.94 h,respectively,in the ovarian cancer patients in the experimental group,compared with the control group,which was 29.55±11.97 h,59.18±17.49 h and 56.40±17.57 h,the differences were statistically significant(P < 0.05).Compared with the control group,the NRS score of the experimental group significantly decreased at 12 h after operation(P < 0.05).There was no significant difference in the incidence of postoperative complications,NRS score at 24 h and 48 h between the two groups(P > 0.05).Conclusion : The application of ERAS perioperative treatment in laparoscopic surgery for gynecological malignant tumors can significantly shorten the time for the first postoperative exhaust,defecation and the first time to get out of bed,significantly reduce the incidence of postoperative fever,relieve pain and promote postoperative recovery.