The application value of ERAS in perioperative management of endoscopic treatment for rNPC patients
10.3969/j.issn.1671-8348.2025.10.029
- VernacularTitle:ERAS在内镜治疗rNPC患者围手术期管理中的应用价值
- Author:
Fan YANG
1
;
Li LI
;
Siying LI
Author Information
1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈肿瘤综合科,北京 100730
- Keywords:
recurrent nasopharyngeal carcinoma;
enhanced recovery surgery;
perioperative manage-ment;
generalized estimation equation;
random forest algorithm
- From:
Chongqing Medicine
2025;54(10):2401-2406
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application value and influencing factors of the enhanced recovery surgery(ERAS)concept in perioperative management of patients with recurrent nasopharyngeal carcinoma(rNPC)undergoing endoscopic treatment.Methods A total of 120 patients diagnosed with rNPC from No-vember 2022 to November 2023 were selected and divided into a routine nursing group and an ERAS group,with 60 cases in each group.The routine nursing group received perioperative care according to the hospital's routine procedures,while the ERAS group received perioperative management according to ERAS.Video per-spective swallowing function test(VFSS),Wada drinking water test(WST),and functional assessment of cancer therapy-head and neck(FACT-H&N)were used to evaluate the swallowing movement,swallowing difficulties,and quality of life of patients with head and neck tumors.Visual analog scale(VAS)was used to assess pain levels and record patient hospitalization and bed rest time.The importance of ERAS management was verify in the prognosis and rehabilitation process of this type of patient using generalized estimation equa-tions(GEE)and random forest algorithm(RF).Results ERAS group had significantly better oral transport time,swallowing function initiation time,and time interval through the cricopharyngeal muscle in VFSS com-pared to the conventional nursing group,with statistical significance(P＜0.05).The WST score of the ERAS group was lower than that of the conventional nursing group,and the difference was statistically significant(P＜0.05).Three months after surgery,except social/family and emotional conditions,the FACT-H&N scores of both groups of patients decreased significantly compared to preoperative levels,and the physiological condition score,core scale total score,head and neck module score,and scale total score of the ERAS group were higher than those of the conventional nursing group(P＜0.05).Six months after surgery,the total scores of the core scale,head and neck module,and scale in the ERAS group were significantly higher than those in the conventional nursing group(P＜0.05).The hospitalization time and bed rest time of the ERAS group were significantly shorter than those of the conventional nursing group,and the VAS score was signifi-cantly lower than that of the conventional nursing group,with statistical significance(P＜0.05).The GEE and RF validation results showed that the hospitalization time(OR=1.242,95％CI:1.175-1.762),total score of the scale(OR=0.899,95％CI:0.323-0.994),orofacial transit time(OR=1.113,95％CI:1.013-1.503),onset time of swallowing function(OR=1.365,95％CI:1.278-1.945),and WST score(OR=1.326,95％CI:1.023-1.965)were the five items with the best improvement effect in the ERAS group.Con-clusion ERAS management can effectively improve the prognosis and quality of life of rNPC patients after endoscopic surgery.
