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"THE ACCELERATED RECOVERY PROGRAM" IN PATIENTS WITH ECTOPIC PREGNANCY

Sulima A. N., Basnaeva A. D., Rybalka A. N., Basnaev U. I., Mykhaylichenko V. Yu., Karakursakov N. E.

Aim is to study and to estimate the results of “the accelerated recovery program (ARP)” applying when treating the women with terminated tubal pregnancy. Materials and methods. At the core of our experimental investigation was the comparative analysis of the results of the management of the women with an aborted ectopic pregnancy who had been treated in the State budgetary institution of health care in Crimea Republic Simferopol Clinical Maternity Hospital № 1 from 2017 to 2019. We formed 2 groups – an index group (52 women): they had been treated from 2018 till 2018, we made prospective analysis upon “the accelerated recovery program”; and an experimental one (41 women): we performed retrospective analysis; their treatment was made according to the national clinical recommendations. Results. “The accelerated recovery program” applying permitted to get an appropriate analgesia level in post-operative period under condition of narcotic opioids refusal and usage of non-steroid analgesics combination. During the entire follow-up period the pain level wasn’t more than 4 scores in VAS (Visual Analog scale) (р˂0,05). Based on the data analysis of Questionnaire SF-36 it was revealed that the index group life quality level of 36 women (69,2%) corresponded to an increased one at the time of discharge from the hospital. When in the same period life quality level of 31 females (75,6%) from the experimental group corresponded to an average one (p<0,05). Analysis of the recovery period of the gastrointestinal tract motor function showed that 10 (23,4%) women from the experimental group were registered to have nausea in the first day, 8 (19,5%) females had vomiting. Index group patients didn’t complain on nausea; vomiting was registered at 2 (3,8%) persons (p<0,05). Restoration of peristalsis and the beginning of gas discharge in index women group started on average in 16,8±2,4 hours; in the experimental one- averagely in 26,5±1,3 hours (p<0,05). First defecation was registered averagely in 32,4±3,1 hours in the index group; in the experimental one it was in about 48,6±2,9 hours after the operation (p<0,05). We see that intestinal functioning restoration was in 1,5 faster in the index group than in the experimental one. An average hospital stay for the index women group was 5,8±1,2 days (p<0,05); for the ones from the experimental group it was 7,1±1,1 days. Conclusions. In the course of the investigative work we received the results which proved the possibility and efficiency of “the accelerated recovery program” applying in case of surgical treatment for terminated tubal pregnancy. The use of this technique has allowed to reduce the period of in-patient treatment not due to only early physical, but also psychological rehabilitation after the surgery. Key words: “accelerated recovery program”, ectopic pregnancy, terminated tubal pregnancy.

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