加速康复外科措施对正颌手术患者术后恢复质量的影响

doi:10.19438/j.cjoms.2025.06.007

摘要/Abstract

摘要： 目的：比较不同加速康复外科（enhanced recovery after surgery,ERAS）措施依从率对正颌手术患者术后恢复质量的影响。方法：采用回顾性队列研究,收集2020年9月—2023年2月于空军军医大学第三附属医院行择期正颌手术患者的信息。根据ERAS措施依从率,将患者分为2组,即低依从性组（依从率<80%）和高依从性组（依从率≥80%）。采用倾向性评分匹配对两组患者进行匹配,每组各127例。主要研究指标为术后1天40项恢复质量评分量表（Quality of Recovery-40,QoR40）评分。次要研究指标为术后3、5、7、14天QoR40评分,术后1天疼痛评分,ERAS措施与术后1天QoR40评分的相关性。结果：高依从性组患者术后1天QoR40评分显著高于低依从性组（P<0.05）,前者QoR40量表中的舒适度评分也更高、疼痛评分更低（P<0.05）。两组患者术后3、5、7、14天QoR40评分差异无统计学意义（P>0.05）。术中应用抗生素、静脉麻醉维持、体温管理、气道管理、术后恶心与呕吐防治、苏醒期平稳过渡、术后早期下床与患者术后1天QoR40评分存在正相关性（P<0.05）。结论：ERAS措施依从性高于80%时,可改善正颌手术患者术后1天恢复质量,提高患者舒适度。

关键词: 加速康复外科, 术后恢复质量, 正颌手术

Abstract: PURPOSE: To compare the impact of different compliance rates of enhanced recovery after surgery (ERAS) measures on the postoperative recovery quality of patients undergoing orthognathic surgery. METHODS: A retrospective cohort study was conducted to collect the information of patients who underwent elective orthognathic surgery at the Third Affiliated Hospital of Air Force Military Medical University from September 2020 to February 2023. According to the compliance rate of ERAS measures, the patients were divided into two groups: the low compliance group (compliance rate <80%) and the high compliance group (compliance rate≥80%). Propensity score matching was used to match the two groups of patients, with 127 cases in each group after matching. The primary outcome was the 40-item recovery quality score scale (Quality of Recovery-40, QoR40) on the first postoperative day. Secondary outcomes included QoR40 scores on postoperative days 3, 5, 7, and 14, the pain scores one day after surgery, and the correlation between ERAS measures and the QoR40 score on the first postoperative day. RESULTS: The QoR40 scores on the first postoperative day in the high compliance group were significantly higher than those in the low compliance group (P<0.05). The comfort score in the five dimensions of the QoR40 score was higher and the pain scores was lower in the former group (P<0.05). There were no significant difference in QoR40 scores on postoperative days 3, 5, 7, and 14 between the two groups(P>0.05). The application of antibiotics during operation, maintenance of intravenous anesthesia, body temperature management, airway management, prevention and treatment of postoperative nausea and vomiting, no agitation during the recovery period, and early postoperative ambulation were positively correlated with the QoR40 score of patients one day after operation (P<0.05). CONCLUSIONS: With the compliance of ERAS measures higher than 80%, the quality of recovery and the comfort on the first postoperative day in patients undergoing orthognathic surgery is significantly enhanced.

Key words: Enhanced recovery after surgery, ERAS, Postoperative quality of recovery, Orthognathic surgery

中图分类号:

R782.2
R493

刘畑畑, 吴宇飞, 王晓霞, 张瑞斌, 荀泽敏, 张惠. 加速康复外科措施对正颌手术患者术后恢复质量的影响[J]. 中国口腔颌面外科杂志, 2025, 23(6): 578-585.

Liu Tiantian, Wu Yufei, Wang Xiaoxia, Zhang Ruibin, Xun Zemin, Zhang Hui. The impact of enhanced recovery after surgery measures on postoperative recovery quality in patients after orthognathic surgery[J]. China J Oral Maxillofac Surg, 2025, 23(6): 578-585.

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