| BackgroundRapid rehabilitation surgery（ERAS）[1]is a new concept and treatment modality in the field of surgery.Refers to in order to reduce the stress and the occurrence of postoperative complications,reduce the case fatality rate,speed up the patient’s postoperative recovery and shorter hospital stay and a series of measures,has realized from the traditional biomedical model to biopsychosocial medical model transformation.And since 1991 the world’s first successful laparoscopic liver resection,because of little injury and pain,rapid recovery,and analgesic drugs need less and less postoperative complications,and shorter hospitalization time,together with the development of surgical instruments,has been widely recognised and thorough development.However,the influence of ERAS on laparoscopic hepatectomy is not very clear,and the implementation of clinical work is lack of scientific evidence.The purpose of this research is to accelerate the integration of rehabilitation surgery and minimally invasive technology as soon as possible,so as to enable new ideas and technologies to accelerate the effective benefits to the people.ObjectiveTo explore the safety,feasibility,efficacy and superiority of accelerated rehabilitation surgery in the application of hepatectomy.Analysis of the problems of two ideas inpractical clinical application.and to provide a small sample quantity and evidence-based basis for the application of ERAS theory in the research of precise liver resection.MethodsReview of henan province people’s hospital of liver and gallbladder surgery in January 2015-February 2017 were successful,126 cases of patients with laparoscopic liver resection is divided into two groups by random number table method,the experimental group（ERAS）63 cases and control group 63 cases,among which use rapid rehabilitation perioperative ERAS measures,control group applied traditional perioperative measures for our department.Personal data on two groups of patients,Intraoperative bleeding,the cure rate and postoperative 1,3,7 day white blood cells and CRP,operation time,postoperative exhaust time,defecation time and hospitalization time,on the day of surgery,infusion quantity and cost of hospitalization and follow-up data were retrospective statistical analysisResultsThe cure rate of experimental group was 98.4%and 93.6%higher than the control group,but the difference was not statistically significant（P>0.05）;the experimental group after 1,3,7 days of white blood cell values were 0.79（0.59,0.91）,0.65（0.44,0.76）,0.82（0.57,0.95）10^9/L and control group were 0.85（0.57,0.95）,0.62（0.45,0.68）,0.70（0.52,0.82）10^9/L,there was no statistically significant difference（P>0.05）;the experimental group operative time was 4.173±0.467h shorter than that of the control group was 4.441±0.602h,postoperative exhaust time shorter than the control group43.92+8.35h 59.33+6.95h,55.78（48,63）H defecation time shorter than the control group（74.33 69,73 h）,7.63（7,8）d hospitalization time shorter than the control group 8.48（7,9）d,the amount of intraoperative bleeding in experimental group than in the control group 154±13.7ml 231±12.4ml,the day of surgery transfusion 2914.29±308.41ml3173.02±382.78ml shorter than the control group,the hospitalization expenses of 6.795（6.4,7.1）yuan was lower than the control group 7.148（6.8,7.5）million yuan,1,3 and 7days after operation,CRP were 45.65±1.14,109.67±1.46 and 29.17（24.00,33.00）mg/L respectively,which was lower than that of the control group 50.70,126.32±1.53 and37.10（32.00,42.00）.The difference was statistically significant（P<0.05）.ConclusionThe eras in laparoscopic accurate hepatectomy is safe,feasible and effective,and has obvious advantages in postoperative rehabilitation,hospital cycle and medical cost. |
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