探究快速康复外科（ERAS）理念在机器人辅助食管裂孔疝修补术（RHHR）患者围手术期中应用的效果。

回顾性分析2022年10月至2024年12月于新疆维吾尔自治区人民医院微创外科、疝与腹壁外科住院行RHHR的患者60例，根据护理方式不同分为ERAS组和对照组各30例，对照组给予常规护理，ERAS组在此基础上加入ERAS理念。采用单因素分析（Wilcoxon符号秩和检验、t检验、χ²检验）比较2组术后首次进食时间、术后首次排气和排便时间、术后住院时间、总住院时间、住院花费、术后疼痛评分、血栓栓塞风险（VTE）及术后并发症发生率的差异。

与对照组相比，ERAS组术后首次进食时间[8.0（6.0，15.0）h vs 14.0（10.0，21.0）h]、术后首次排气时间[10.0（9.0，12.0）h vs 20.0（16.0，23.0）h]和术后首次排便时间[12.0（10.0，13.0）h vs 21.0（17.7，25.0）h]均显著提前，术后住院时间[3.5（2.0，4.2）d vs 6.0（4.0，10.5）d]、总住院时间[12.5（9.0，14.3）d vs 19.0（14.0，23.0）d]也显著缩短，差异具有统计学意义（Z=-5.440、-5.598、-5.687、-3.858、-3.880，P均<0.001）。ERAS组的住院花费（59 111±11 670元）低于对照组（73 533±14 632元），差异具有统计学意义（t=-4.220，P<0.001）。ERAS组的术后第1、2、3天疼痛评分均显著低于对照组[2.0（2.0，4.0）分vs 4.0（4.0，4.0）分；1.0（0，1.0）分vs 2.0（1.7，2.0）分；0（0，1.0）分vs 1.0（0，1.0）分]，差异具有统计学意义（Z=-3.768、-6.134、-2.531，P<0.001、<0.001、=0.011）。在血栓栓塞风险（VTE）方面，ERAS组患者出院当天的VTE评分低于对照组[0（0，1）分vs 1（0，1）分]，差异具有统计学意义（Z=-2.393，P=0.017）。此外，ERAS组术后咳嗽咳痰的发生率低于对照组（1/30 vs 7/30），差异具有统计学意义（χ²=5.192，P=0.023）。

ERAS围手术期护理可促进RHHR患者胃肠功能恢复，缩短住院时间，减少术后疼痛以及住院花费。

To investigate the efficacy of enhanced recorery after surgery (ERAS) nursing in patients undergoing robot-assisted hiatal hernia repair (RHHR).

A retrospective analysis was conducted on 60 patients who were hospitalized for RHHR in the Minimally Invasive Surgery Department, Hernia and Abdominal Wall Surgery Department of Xinjiang Uygur Autonomous Region People’s Hospital from October 2022 to December 2024. The patients were divided into an ERAS group and a control group, with 30 patients in each group, based on their nursing care. The control group received routine nursing care, while the ERAS group received ERAS-based nursing care in addition to routine care. Comparison of postoperative first oral intake time, first defecation time, postoperative hospital stay, total hospitalization duration, economic benefits, postoperative pain scores, venous thromboembolism (VTE) risk, and incidence of postoperative cough and sputum production between the two groups by Wilcoxon signed rank sum test, t-test and χ² test.

ERAS group demonstrated significantly improved postoperative recovery, with earlier first oral intake [8.0(6.0, 15.0)h vs 14.0(10.0, 21.0)h; Z=-5.440, P<0.001], first flatus [10.0(9.0, 12.0)h vs 20.0(16.0, 23.0)h; Z=-5.598, P<0.001], and first bowel movement [12.0(10.0, 13.0)h vs 21.0(17.7, 25.0)h; Z=,-5.687 P<0.001] when compared to the control group, furthermore, the ERAS group experienced significantly shorter postoperative hospital stay [3.5(2.0, 4.2)d vs 6.0(4.0, 10.5)d; Z=-3.858, P<0.001] and total hospitalization duration [12.5(9.0, 14.3)d vs 19.0(14.0, 23.0)d; Z=-3.880, P<0.001], when compared to the control group. Economically, total costs were significantly lower in the ERAS group [(59 111±11 670)yuan vs (73 533±14 632)yuan] compared to the control group (t=-4.220, P<0.001). Pain scores were significantly lower in the ERAS group on postoperative days [2.0(2.0, 4.0)vs 4.0(4.0, 4.0); Z=-3.768, P<0.001] and 2 [1.0(0, 1.0)vs 2.0(1.7, 2.0); Z=-6.134, P<0.001], and also on day 3 [0(0, 1.0) vs 1.0(0, 1.0); Z=-2.531, P=0.011], when compared to the control group. The ERAS group also showed a lower VTE score on discharge day [0(0, 1) vs 1(0, 1); Z=-2.393, P=0.017] and a significantly lower incidence of postoperative cough and sputum (1/30 vs 7/30; χ²=5.192, P=0.023) when compared to the control group.

ERAS perioperative nursing can promote gastrointestinal function recovery, shorten hospital stay, reduce postoperative pain and hospitalization cost in patients undergoing robotic hiatal hernia repair.