探讨加速康复外科（ERAS）在腹腔镜肝囊型包虫病根治术中的应用价值。

回顾性分析2016年1月至2017年11月在新疆维吾尔自治区人民医院行腹腔镜完整包虫外囊切除术的38例肝囊型包虫病患者临床资料。其中男24例，女14例；年龄17～70岁，中位年龄46岁。患者均签署知情同意书，符合医学伦理学规定。采用ERAS方案治疗者24例，设为ERAS组；采用传统方案治疗者14例，设为传统组。两组患者围手术期情况比较采用t检验，率的比较采用χ2检验或Fisher确切概率法。

ERAS组术后下床活动时间、术后肛门排气时间和术后引流管拔除时间分别为（1.5±0.4）、（1.4±0.6）、（6.4±1.1）d，明显少于传统组的（3.4±0.6）、（2.6±0.5）、（8.2±1.3）d（t=-2.56、-3.91、-2.75；P<0.05）。ERAS组手术时间和术中出血量分别为（132±25）min、（240±30）ml，传统组相应为（26±21）min、（191±15）ml，差异无统计学意义（t=0.68、0.80；P>0.05）。ERAS组中转开腹2例，传统组无中转开腹，差异无统计学意义（P>0.05）。ERAS组、传统组术后并发症发生率分别为17%（4/24）、14%（2/14），差异无统计学意义（χ2=0.846，P>0.05）。随访期间两组均无复发，无发生腹腔积液、重大心脑血管并发症。

ERAS应用于腹腔镜下肝囊型包虫病根治术有效，可加快患者术后康复，缩短住院时间，且不增加手术风险和术后并发症发生。

To explore the application value of enhanced recovery after surgery (ERAS) in the laparoscopic radical resection of hepatic cystic echinococcosis.

Clinical data of 38 patients with hepatic cystic echinococcosis undergoing laparoscopic total external cystectomy in Xinjiang Uygur Municipal People's Hospital from January 2016 to November 2017 were retrospectively analyzed. Among them, 24 patients were male and 14 female, aged 17-70 years with a median age of 46 years. The informed consents of all patients were obtained and the local ethical committee approval was received. 24 patients who were treated with ERAS program were assigned into the ERAS group and 14 patients receiving traditional therapy were allocated in the traditional group. The perioperative conditions were statistically compared between two groups by t test. The rate comparison was performed by Chi-square test or Fisher's exact test.

The postoperative off-bed ambulation time, postoperative exhaust time and postoperative removal time of drainage tube in the ERAS group were (1.5±0.4), (1.4±0.6) and (6.4±1.1) d, significantly shorter than (3.4±0.6), (2.6±0.5) and (8.2±1.3) d in the traditional group (t=-2.56, -3.91, -2.75; P<0.05). In the ERAS group, the operation time and intraoperative blood loss were (132±25) min and (240±30) ml, which did not significantly differ from (26±21) min and (191±15) ml in the traditional group (t=0.68, 0.80; P>0.05). In the ERAS group, 2 cases were converted to open surgery and none in the traditional group, where no significant difference was observed (P>0.05). The incidence of postoperative complications in the ERAS and traditional groups was 17% (4/24) and 14% (2/14), respectively, where no significant difference was observed (χ2=0.846, P>0.05). During the follow-up, no recurrence, peritoneal effusion or major cardiovascular and cerebrovascular complication occurred.

ERAS is an efficacious approach for laparoscopic radical resection of hepatic cystic echinococcosis, which can accelerate postoperative recovery and shorten the length of hospital stay without increasing the surgical risk and postoperative complications.