Application Of Enhanced Recovery After Surgery In 294 Cases Of Gynecological Malignant Tumor During Perioperative

Objective: To explore the application effect of enhanced recovery after surgery(ERAS)in the perioperative period of gynecological malignant tumors by comparing with the traditional perioperative management mode.Methods:1.A total of 580 inpatients who were diagnosed with ovarian cancer,endometrial cancer and cervical cancer by gynecological surgery and pathology in the Fourth Hospital of Hebei Medical University from December2018 to January 2021 were selected.They were randomly divided into the intervention group(294 cases)and the control group(286 cases).The intervention group received the ERAS pathway during the perioperative period,and the control group received the conventional pathway during the perioperative period.Both groups were performed by the same surgical,anesthetic and corresponding nursing team.Compared two groups of hospitalized days and preoperative anxiety and depression(SAS,SDS)score,operation time,intraoperative blood loss,intraoperative rehydration capacity,exhaust defecation time,many for the first time period pain(VAS)score,on the third day after physical activity(ECOG)score,postoperative complications and length of hospital stay,cost factors,assessment in the gynecology malignant tumor perioperative application effect.2.SPSS 21.0 statistical software was used.T-test was used for measurement data,Chi-square test was used for counting data,and rank sum test was used for grade data.P<0.05 indicated statistically significant difference.Results:1.There were no significant differences in general data between the two groups: age,body mass index(BMI),disease type and surgical method(P>0.05).2.The number of preoperative hunger and thirst in the control group was significantly higher than that in the intervention group,and the difference between the two groups was statistically significant(P<0.05).3.The SAS and SDS scores of the intervention group and the control group were(55.87±7.87,36.27±4.86),(55.55±8.38,44.16±6.51),(60.37±8.21,38.79±5.17),and(60.00±8.29 47.09±6.30)respectively.There was no significant difference in the SAS and SDS scores between the two groups on the admission day(P>0.05).After intervention,the degree of anxiety and depression in 2 groups was reduced compared with before intervention,with statistical significance(P<0.05).SAS and SDS scores in the intervention group were significantly different from those in the control group(P<0.05).4.There were no significant differences in operative time(190.90±35.31 min,192.89±37.66min)and intraoperative blood loss(179.17±48.08 ml,182.77±41.24ml)between the two groups(P>0.05).The intraoperative fluid volume(1778.40±203.18ml)in the intervention group was significantly lower than that in the control group(2076.05±238.11ml),with statistical differences(P<0.05).5.The time of first postoperative exhaust and first defecation in the intervention group(24.99±5.55 h,78.37±20.96h)was higher than that in the control group(20.45±4.37 h,70.64±18.33h),and the difference was statistically significant(P<0.05).6.VAS scores in the treatment group were(1.07±0.80,2.20±0.87,2.02±0.78,1.04±0.82,0.61±0.51)at 2h,6h,12 h,24h,and 36 h after surgery,and those in the control group were(1.10±0.79,3.07±0.81,2.90±0.78,1.55±0.52,1.33±0.50),respectively.Among them,there was no statistically significant difference in the VAS score at 2h after surgery(P>0.05),and the VAS score at 6h,12 h,24h and 36 h after surgery in the control group was higher than that in the intervention group,with statistically significant difference(P<0.05).7.ECOG score on the third day after surgery: the number of 0,1,2,3scores in the intervention group was 164,72,36,22,respectively,while that in the control group was 123,85,63,15,respectively,with statistical significance between the two groups(P<0.05).8.Complications occurred in 29 patients(9.86%)during the hospitalization intervention,compared with 45 patients(15.73%)in the control group.The incidence of complications in control group was higher than that in intervention group,and the difference was statistically significant(P<0.05).9.The postoperative hospitalization time and medical expenses in the intervention group were 4.91±0.77 days and 47290.29±3403.31 yuan respectively,and those in the control group were 5.09±0.83 days and50015.78±3298.60 yuan respectively,with statistical significance between the two groups(P<0.05).Conclusion:In 294 patients with gynecological malignant tumor,perioperative application of ERAS is safe and effective for patients,which is conducive to promoting postoperative recovery,reducing patients’ negative emotions and discomfort,reducing postoperative complications,reducing patient hospitalization time and saving medical costs.