Abstract:

Objective　To investigate the efficacy and safety of enhanced recovery after surgery (ERAS) in the perioperative period of endoscopic myringoplasty. Methods　This was a randomized controlled trial. A total of 40 patients with chronic suppurative otitis media stationary phase who underwent endoscopic myringoplasty in Fengcheng People's Hospital from January 2021 to June 2022 were prospectively selected as the study objects, and were divided into a ERAS group (20 cases) and a control group (20 cases) by the random number table method. In the ERAS group, there were 4 males and 16 females, aged (45.7±11.6) years, and the perioperative management was performed using ERAS model. In the control group, 5 males and 15 females, aged (46.5±12.4) years, were treated with traditional perioperative management. The preoperative anxiety, postoperative comfort, pain, adverse reactions, length of stay, and hospitalization cost were compared between the two groups. t test and χ² test were used. Results　The preoperative Self-rating Anxiety Scale (SAS) score of the ERAS group was (27.31±1.54) points, which was lower than that of the control group [(34.82±5.13) points], with a statistically significant difference (t=6.270, P<0.001). On day 1 and day 2 after surgery, the Kolcaba General Comfort Questionnaire (GCQ) score of the ERAS group was higher than that of the control group [(89.53±7.85) points vs. (83.24±7.21) points, (87.31±7.67) points vs. (81.03±8.45) points], but the VAS score was lower than that of the control group [(1.73±1.12) points vs. (3.00±1.31) points, (1.59±1.06) points vs. (2.78±1.27) points], with statistically significant differences (t=2.639, 2.461, 3.295, and 3.217, all P<0.05). There were no statistically significant differences in the length of stay or hospitalization cost between the two groups (t=0.914 and 1.464, both P>0.05). There was no bleeding in the ear incision, and no adverse events such as vertigo, nausea, vomiting, or aspiration occurred in the two groups. Conclusion　ERAS has definite effects in the perioperative period of endoscopic myringoplasty, which can relieve the preoperative anxiety, reduce the postoperative pain, and improve the postoperative comfort.

Key words:

Enhanced recovery after surgery, Otoscope, Myringoplasty, Perioperative management

摘要：

目的　探讨加速康复外科（ERAS）在耳内镜下鼓膜修补术围手术期的有效性和安全性。方法　本文为随机对照试验。前瞻性选取2021年1月至2022年6月丰城市人民医院收治并进行耳内镜下鼓膜修补术的40例慢性化脓性中耳炎静止期患者作为研究对象，采用随机数字表法将其分为ERAS组（20例）和对照组（20例）。ERAS组男4例、女16例，年龄（45.7±11.6）岁，采用ERAS模式进行围手术期管理；对照组男5例、女15例，年龄（46.5±12.4）岁，采用传统的围手术期管理。对比两组患者术前焦虑情况及术后舒适度、疼痛、不良反应、住院时间、住院费用。采用t检验、χ²检验。结果　ERAS组患者术前焦虑自评量表（SAS）评分为（27.31±1.54）分，低于对照组的（34.82±5.13）分，差异有统计学意义（t=6.270，P<0.001）。术后1 d、2 d，ERAS组患者Kolcaba的舒适状况量表（GCQ）评分均高于对照组［（89.53±7.85）分比（83.24±7.21）分、（87.31±7.67）分比（81.03±8.45）分］，视觉模拟评分法（VAS）评分均低于对照组［（1.73±1.12）分比（3.00±1.31）分、（1.59±1.06）分比（2.78±1.27）分］，差异均有统计学意义（t=2.639、2.461、3.295、3.217，均P<0.05）。两组患者住院时间及住院费用比较，差异均无统计学意义（t=0.914、1.464，均P>0.05）。两组患者术后耳部切口无出血，患者无眩晕、恶心、呕吐及误吸等不良事件发生。结论　ERAS用于耳内镜下鼓膜修补术围手术期的效果确切，能缓解患者术前焦虑情绪，减轻患者术后疼痛，提高患者术后舒适度。

关键词:

加速康复外科, 耳内镜, 鼓膜修补术, 围手术期管理