加速康复外科理念在内镜经鼻颅底肿瘤切除术的围手术期应用

Application of Enhanced Recovery After Surgery Concepts in the Perioperative Period for Endoscopic Endonasal Skull Base Tumor Resection

摘要:

目的 探讨加速康复外科（ERAS）理念在内镜经鼻颅底肿瘤切除术围手术期的应用效果和临床经验总结。方法 回顾性分析2026年1月至6月首都医科大学宣武医院耳鼻咽喉头颈外科收治的鼻颅底肿瘤患者，均行内镜经鼻颅底肿瘤切除术，围手术期实施ERAS路径；对比2025年收治的行内镜经鼻颅底肿瘤切除术的患者，在年龄、肿瘤位置、病理类型、修补材料等基线特征上进行比较；对比两组患者的并发症发生率、术后疼痛评分、术后住院日、住院费用等。结果 实施ERAS组患者66例，对照组147例，两组在基线特征上没有统计学差异。ERAS组术后住院日8.48±2.47天少于对照组9.31±2.94天，P<0.05，差异有统计学意义。结论 ERAS路径的实施有助于缩短术后住院日，ERAS组患者的平均住院日、住院次均费用均较对照组有所降低，体现出ERAS在内镜颅底外科治疗中的有益价值，后续有待扩大样本量，更充分地显示该路径的优势。

Abstract:

Abstract: Objective To investigate the application effects and summarize the clinical experiences of Enhanced Recovery After Surgery (ERAS) for the perioperative management of endoscopic endonasal skull base tumor resection. Methods We retrospectively analyzed patients who had been diagnosed with skull base tumors at the Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, from January to June 2026. These patients received endoscopic endonasal skull base tumor resection using an ERAS protocol that was applied perioperatively. Patients receiving the same surgery in 2025 were also considered; we compared their baseline characteristics including age, tumor location, pathological type, and reconstruction materials. Two groups were then compared regarding complications, postoperative pain score, postoperative length of stay, and hospitalization cost. Results There were sixty-six patients enrolled in the ERAS group and 147 in the control group. No statistically significant differences existed among the baseline characteristics of both groups. Average postoperative hospital stay of the ERAS group is 8.48±2.47 days while it''s 9.31±2.94 days in the control group, with P<0.05, and the difference is statistically significant. Conclusion Implementation of the ERAS protocol shortened postoperative length of stay. The mean hospital stays and average cost per admission decreased slightly in the ERAS group when compared to the control group, highlighting the importance of ERAS in endoscopic skull base surgery. Larger samples should be studied further so as to elucidate the benefit of this pathway.