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摘要译文
目的
探讨加速康复外科( EＲAS) 围手术期管理在垂体腺瘤假性包膜外经鼻蝶手术病人的临床应用价值。方法6月~12月需手术治疗的垂体腺瘤病人122例，其中ERAS组65例，采用ERAS临床路径，对照组57例，采用传统临床路径。比较两组病人术前术后卡氏( KPS) 评分，术前准备时间，术后住院时间，肿瘤切除率，术后尿崩，脑脊液漏等主要并发症发生率及住院期间满意度。结果ERAS组自术后1天至术后30天的KPS评分高于对照组( P＜0．05)。ERAS组病人住院期间病人满意度高于对照组，差异有统计学意义( P＜0．05) 。ERAS组术后住院时间和卧床时间明显缩短( P＜0．05) 。EＲAS 组肿瘤全切率为 83．08% ，对照组为82．46% ，差异无统计学意义( P＞0．05) 。对照组术后尿崩、鼻腔大出血的发生率高于ERAS组( P＜0．05) 。结论垂体腺瘤经鼻蝶假性包膜外切除是 EＲAS 的最好体现，同时兼顾了微创手术理念和最大限度的功能保护，在围手术期贯彻 EＲAS 是提高垂体瘤手术病人疗效和满意度，减少术后并发症发生的重要措施之一。
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Enhanced recovery after surgery in pseudocapsule based pituitary adenectomy
CHEN Juan，GUO Xiang，YAN Zisheng，et al．Department of Neurosurgery，Tongji HospitalJ Clin Surg，September ，Vol． 27，No． 9DOI：0．3969 /j.issn.1005-6483．．09．011
ObjectiveTo explore the management measure of enhanced recovery after surgery(ERAS) in patients with pseudocapsule based microsurgery for transsphenoid pituitary adenoma．
MethodsFrom June to December ，122 patients with pituitary adenoma treated with pseudocapsule based extracapsular transsphenoid microsurgery，and 65 patients were in the ERAS group and 57 in controlgroup，clinical materials and follow-ups were retrospectively analyzed．
ResultsCompared to the control group with classical perioperative management，the ERAS group had better KPS grades( P ＜ 0． 05) andmore satisfaction at in-hospital duration( P ＜ 0．05) ，shorter in-hospital time( P ＜ 0． 05) and in-bed time ( P ＜ 0． 05) ，meanwhile less complication rate of epitaxies and diabetes( P ＜ 0． 05) ．
ConclusionThe integration of ERAS concept into the pituitary surgery with extra-pseudocapsule mode could minimize the surgical trauma and maximize the function protection for neurosurgical patients． The ERAS management was crucial to improve the surgical effect and patients’experience during hospitalization，it is worthy to generalize it in clinical practice．
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