The Clinical Application Of Enhanced Recovery After Surgery In The Treatment Of Acute Abdominal Disease

Objective:To investigate the significance of enhanced recovery after surgery(ERAS)for treatment in patients with acute abdominal disease.Methods:From Sep Ist 2015 to Sep 1st 2017,547 patients with acute abdominal disease and admitted in the Hospital were collected.In accordance with the proposed inclusion criteria and exclusion criteria,480 patients were divided into ERAS group and conservative treatment surgery(CTS)group randomly finally.There were 280 males and 200 females,average age(55.23+17.87)and average weight(53.76+20.32)kg.We retrospectively analysis the clinical data of the patients;the patients in ERAS group and CTS group were intervened among the perioperative period respectively,collected common information of patients among the perioperative period,ncluding gender,age,disease sorts and disease score;biochemical index:before and 1 days,3 days,7 days after emergency operation of serum CRP,PA changes;emergency operation related indicators:the operation time,amount of bleeding,the first postoperative ambulation time,postoperative intestinal function recovery time,the time of enteral nutrition.the incidence of complications,postoperative pain grade,hospitalization time and hospitalization expenses.Results:1.There was no significant difference between ERAS and CTS in patients with operation time and bleeding amount in the operation(P>0.05);but postoperative recovery of gastrointestinal function in ERAS group,the exhaust time,was less than CTS group,and the difference was statistically significant(P<0.001);ERAS group onsetting enteral nutrition and first ambulation time is also less than those in CTS group,and the difference was statistically significant(P<0.05);2.There was no significant difference in CRP level between ERAS group and CTS group before operation(P>0.05).CRP level increased in the two groups on the first day after operation,but the CRP level in ERAS group was lower than that in CTS group(P<0.01).The level of serum CRP began to decrease at the 3,7 days after operation,and the level of CRP in group ERAS was lower than that in group CTS(P<0.01,P<0.01).There was a statistically significant difference in the transverse comparison between ERAS and CTS level(P<0.001):3.There was no significant difference in PA level between ERAS group and CTS group before operation(P>0.05);on the first day after operation.the PA level in the two groups decreased.but the PA level in ERAS group was higher than that in CTS group(t=7.34,P<0.01);the level of serum PA began to increase at the 3,7 days after operation,and the level of PA in ERAS group was higher than that in CTS group(P<0.01,P<0.01);there was a statistically significant difference in the transverse comparison between ERAS and CTS level(P<0.001);4.The pain score in ERAS group,was lighter than that in CTS group(P<0.01);the incidence of perioperative complications in group ERAS was 6.34%,lower than that in group CTS(17.92%,P<0.001);hospitalization time and hospitalization expenses in ERAS group were lower than those in CTS group.Conclusions:The application of ERAS among perioperative period of acute abdomen including acute pancreatitis,acute cholecystitis,acute bowel obstruction,gastrointestinal perforation and acute appendicitis in abdomen emergency surgery is safe and feasible,promote recovery of intestinal function,shorten the exhaust time,reduce the pain of patients,reduce complications,accelerate postoperative rehabilitation speed,shorten the hospitalization time,reduce hospitalization expenses.It is safe and practical,and it is worth popularizing and applying in the emergency surgery.