分析加速康复外科（ERAS）在肝癌患者切除术中的治疗效果。

选取2016年1月至2017年7月贵州省人民医院收治的行肝癌切除术患者112例，采用随机数字表分组方法分为常规组（常规肝切除围手术期处理）与ERAS组（加速康复外科程序），各56例。对比两组患者手术相关指标包括术中出血量、术后下床活动时间、术后排气时间、住院时间、术后肝功能恢复时间、住院医疗费用等，视觉模拟评分法（VAS）对术后7 d疼痛情况观察，检测术后7 d肝功能指标包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）等，观察患者术后3个月内并发症情况与30 d内重返入院率，采用问卷调查方式了解患者满意率情况。

ERAS组患者术后下床活动时间、排气时间、住院时间、肝功能恢复时间、住院费用均少于常规组，且疼痛程度更轻，差异有统计学意义（t=2.025、9.371、14.024、4.952、7.394、11.019，均P<0.05）。术后7 d，ERAS组患者ALT、AST、TBIL、AFP指标均显著低于常规组，差异有统计学意义（t=3.123、3.394、3.973、3.987，均P<0.01）。ERAS组术后3个月内并发症发生率及30 d重返入院率分别为7.14%（4/56）、3.57%（2/56），显著低于常规组的21.43%（12/56）、14.29%（8/56），差异有统计学意义（χ²=4.667、3.953，P=0.031、0.047）。ERAS组服务满意度为（98.20±1.50）分，显著高于常规组的（80.56±2.50）分，差异有统计学意义（t=45.278，P<0.01）。

肝癌患者切除术中采用围手术期ERAS程序可改善治疗效果，应在临床实践中推广应用。

To analyze the effect of enhanced recovery after surgery (ERAS) in patients with hepatectomy.

From January 2016 to July 2017, one hundred and twelve patients with hepatectomy in People’s Hospital of Guizhou Province were divided into conventional group (routine hepatectomy perioperative treatment) and ERAS group (accelerated rehabilitation surgery procedure), with 56 cases in each group. The operation related indexes including the amount of intraoperative bleeding, postoperative ambulation time, exhaust time and hospital stay, recovery time of liver function and medical expenses in hospital were compared between the two groups. Visual analogue scale (VAS) was used to observe postoperative pain at 7 d after operation. Liver function indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) were detected at 7 d after operation. The complications within 3 months after operation and the readmission rate within 30 d were observed, and the satisfaction rate of patients was investigated by questionnaire.

In ERAS group, the time of ambulation, exhaust, hospitalization, the recovery time of liver function and the cost of hospitalization were all less than those of the conventional group, and the degree of pain was lighter, the differences were statistically significant (t=2.025, 9.371, 14.024, 4.952, 7.394, 11.019, all P<0.05). The levels of ALT, AST, TBIL and AFP in ERAS group were significantly lower than those in the conventional group, with statistically significant differences (t=3.123, 3.394, 3.973, 3.987, all P<0.01). The incidence of complications within 3 months after operation and readmission rate within 30 d in ERAS group were 7.14% (4/56) and 3.57% (2/56), respectively, which were significantly lower than 21.43% (12/56) and 14.29% (8/56) in the conventional group (χ²=4.667, 3.953, P=0.031, 0.047). Service satisfaction of ERAS group was (98.20±1.50), significantly higher than that of the conventional group (80.56±2.50), and the difference was statistically significant (t=45.278, P<0.01).

Perioperative ERAS can improve the therapeutic effect of liver cancer patients and should be applied in clinical practice.