基于ERAS理念的机器人辅助胃癌手术围手术期液体管理与体温保护研究OA

Objective:To investigate the clinical effects of goal-directed fluid therapy(GDFT)combined with a multimodal thermal protection nursing protocol based on enhanced recovery after surgery(ERAS)principles in patients undergoing robot-assisted gastrectomy(RAG)for gastric cancer.Methods:98 patients who underwent RAG at the First Affiliated Hospital of with Nanjing Medical University from January 2022 to January 2025 were selected.They were randomly divided into the observation group and the control group using a random number table,with 49 patients in each group.The control group received a conventional perioperative care,while the observation group received ERAS-based fluid management and thermal protection.Intraoperative indicators,postoperative recovery indicators and the incidence of complications were compared between the two groups.Results:Total intraoperative fluid intake,central venous pressure at the end of surgery and heart rate in the observation group were all lower than those in the control group(P<0.05).At 1 hour after the start of surgery and at the end of surgery,the core body temperature was higher in the observation group than that in the control group,with the higher mean arterial pressure at the end of surgery and greater intraoperative hourly urine output than the control group(P<0.05).The observation group also had earlier time to first flatus and time to ambulation,with shorter length of hospital stay than the control group(P<0.05).The incidence of hypothermia-related shivering and the overall complication rate were both lower in the observation group than those in the control group(P<0.05).Conclusion:ERAS-based GDFT combined with multimodal thermal protection protocol in patients undergoing RAG for gastric cancer can effectively reduce intraoperative fluid overload,maintain stable body temperature,accelerate postoperative recovery,and lower the risk of complications,making it worthy of widespread application.