目的

探讨加速康复外科（ERAS）理念下的经脐单孔腹腔镜胆囊切除术（LESS）对患者术后恢复的影响。

方法

选取2020年12月至2023年11月120例行LESS的胆囊良性疾病患者，按1：1比例随机分为对照组（n=60例）和观察组（n=60例）。对照组患者采取常规围手术期处理+LESS，观察组患者采取ERAS理念+LESS。使用SPSS25.0软件对数据进行统计学分析，血清应激指标、术后疼痛评定量表（NRS）分值、围手术期指标等计量资料采用（±s）表示，组间比较采用独立样本t检验；术后并发症发生率等计数资料用［例（%）］表示，采用χ²检验。P＜0.05表示差异有统计学意义。

结果

观察组患者术后1d活性氧（ROS）、超氧化物歧化酶（SOD）、丙二醛（MDA）和C反应蛋白（CRP）低于对照组（P＜0.05）；两组患者术后6h、12h、24h和48h的NRS分值比较，观察组更低（P＜0.05）；两组患者术后首次下床、排气恢复、首次进食、住院时间及术中、术后输液量比较，观察组更低（P＜0.05）；观察组患者不良反应总人数占比3.3%低于对照组15.0%（P＜0.05）。

结论

在LESS围手术期中采取ERAS理念下的干预管理，能减小患者手术应激及炎症反应，减轻术后疼痛，促进术后康复，减少不必要输液，降低术后并发症发生率，干预效果显著。

Objective

To explore the influence of transumbilical single-port laparoscopic cholecystectomy （LESS） under the concept of enhanced recovery after surgery （ERAS） on the postoperative recovery of patients.

Methods

A total of 120 patients with benign gallbladder diseases who underwent LESS from December 2020 to November 2023 were selected.They were randomly divided into a control group（n=60 cases） and an observation group （n=60 cases） at a ratio of 1：1.Patients in the control group received conventional peri-operative management plus LESS，while patients in the observation group received ERAS concept-based management plus LESS.The SPSS 25.0 software was used for statistical analysis of the data.Measurement data such as serum stress indicators，numerical rating scale （NRS） for postoperative pain assessment，and peri-operative indicators were expressed as （±s），and independent sample t test was used for comparison between groups； Count data such as the incidence of postoperative complications were expressed as［ cases （%）］，and the χ² test was used.A P value ＜ 0.05 indicated a statistically significant difference.

Results

One day after the operation，the levels of reactive oxygen species （ROS），superoxide dismutase （SOD），malondialdehyde （MDA），and C-reactive protein （CRP） in the observation group were lower than those in the control group （P＜0.05）.The NRS scores of the observation group were lower than those of the control group at 6h，12h，24h，and 48h after the operation （P＜0.05）.In terms of the time to first out-of-bed activity，recovery of exhaust，first eating，length of hospital stay，as well as the intraoperative and postoperative fluid infusion volume，the values in the observation group were lower than those in the control group （P＜0.05）.The proportion of patients with adverse reactions in the observation group was 3.3%，which was lower than 15.0% in the control group （P＜0.05）.

Conclusion

Implementing intervention management under the ERAS concept during the peri-operative period of LESS can alleviate surgical stress and inflammatory responses in patients，relieve postoperative pain，promote postoperative recovery，reduce unnecessary fluid infusion，and lower the incidence of postoperative complications，with a remarkable intervention effect.