科研之友
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摘要
Objective To explore the application value of enhanced recovery after surgery (ERAS) in infants with small intestinal atresia.Methods From September 2016 to December 2020, retrospective analysis of clinical data was performed for 27 neonatal small intestinal atresia operated.From September 2018 to December 2020, 13 infants with small intestinal atresia underwent ERAS during perioperative management.There were 3 boys and 10 girls with an operative age of 2.00(1.00, 3.00) days.From September 2016 to August 2018, 14 infants with traditional perioperative management methods was control group.There were 7 boys and 7 girls with an operative age of 3.00(1.75, 3.25) days.The inter-group differences were compared in terms of time of initiating postoperative enteral nutrition, time of initial postoperative oral feeding, time of initial postoperative flatus, time of initial postoperative bowel movement, time of total intravenous nutrition, length of postoperative hospitalization, postoperative complications, unplanned re-surgery and rate of need for re-surgery.And t-test was utilized for compare the inter-group differences for measures conforming to a normal distribution with homogeneous variance.Non-parametric Mann-Whitney test was employed for other measures; Fisher's exact probability method for comparing count data.Results ERAS and control groups had the same time to start postoperative enteral nutrition [2.0(1.5, 2.5) vs 6.0(5.0, 8.0) days, P<0.0001], time to initial postoperative oral feeding [4.0(3.0, 5.0) vs 9.5(5.0, 11.0) days, P=0.0006], time to initial postoperative flatus [2.0(1.0, 2.0) vs 2.5(2, 3.25) days, P=0.048], time to total intravenous nutrition [12.0(8.5, 13.0) vs 18.0(11.5, 21.5) days, P=0.012] and postoperative hospital stay [20.0(11.0, 24.5) vs 24.5(23.0, 27.0) days, P=0.029]were significantly shorter; time to initial postoperative bowel movement was shorter in ERAS group than that in control group [(3.15±1.63) vs (4.71±3.10) days]. However, the difference was not statistically significant.No statistically significant inter-group difference existed in postoperative related complications, unplanned re-surgery or need for re-surgery. Conclusions ERAS is both safe and feasible for small bowel atresia in infants during perioperative period.It can effectively accelerate the recovery speed of gastrointestinal tract function, shorten the time of total intravenous nutrition and reduce postoperative hospital stay without a higher incidence of complications.
