The Clinical Application Of Enhanced Recovery After Surgery Concept In The Perioperative Period Of Acute Bowel Obstruction

Objective: To investigate the clinical application value of ERAS for perioperative period of acute bowel obstruction.Methods:Adopting the randomized controlled trial,this study included 501 patients with acute bowel obstruction admitted to emergency surgery department in our hospital and underwent emergency surgery treatment during October 2017 to August 2019.According to proposed inclusion and exclusion criteria,470 patients were elected as the research object.They were randomly divided into the ERAS group(276 cases,with perioperative treatment program adopting ERAS concept)and the traditional control group(194 cases,with traditional perioperative treatment measures).Monitor and record the biochemical indicators and general clinical data of the two group patients: changes of plasma CRP,PA and PCT in preoperative 1h and postoperative 1d,3d and 7d;operation duration;intraoperative blood loss;postoperative recovery time of intestinal function;time of the first postoperative feed;incidence of postoperative complications;postoperative pain degree(WHO rating scale);hospitalization time and hospitalization expenses.Results:The CRP and PCT level in postoperative 1d,3d and 7d of ERAS group is lower than those of traditional group,but PA level in postoperative 1d,3d and 7d of ERAS group is higher than that of traditional group.There is statistically significance in the difference between the two groups(P<0.01).In terms of postoperative recovery time of intestinal function,time of the first postoperative feed,incidence of postoperative complications,postoperative pain degree(WHO rating scale),hospitalization time and hospitalization expenses,ERAS group had lower level than the traditional group and there is statistically significance in the difference between the two groups(P<0.01 or P<0.05).Conclusion:The application of ERAS concept in the perioperative period treatment of acute bowel obstruction is secure and feasible.Compared with traditional surgical treatment concepts,ERAS concept can more effectively reduce stress pressure,relieve postoperative pain,promote rapid recovery of postoperative gastrointestinal function,reduce postoperative complications,shorten hospitalization time and reduce hospitalization expenses.It deserves further popularization and application.