摘要
目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念在维和二级医院日间手术围手术期护理中的应用及效果。方法选取联马团中国二级医院2017年5月—2018年3月收住的46例日间手术患者,随机分为ERAS组和对照组,每组23例。通过分析术前禁饮禁食时间、术后寒战、术后疼痛数字等级评定(numeric rating scale,NRS)、术后恶心、呕吐情况、术后下床活动时间、患者满意度、延迟出院事件等指标,评估ERAS护理的效果。结果 ERAS组患者术前禁饮禁食时间缩短,VAS评分在术后2 h、4 h均显著低于对照组(P<0.05),但术后8 h的评分与对照组相比,差异无统计学意义(P>0.05);此外,ERAS组患者术后早期下床时间和护理服务满意度均明显优于对照组(P<0.05),但术后恶心、呕吐及延迟出院事件与对照组相比,差异无统计学意义(P>0.05)。结论基于ERAS理念的护理措施,可以有效降低二级医院日间手术围手术期患者术后并发症及不良事件发生,同时提高患者对日间手术护理的满意度。
Objective To investigate the clinical application and its efficacy of nursing care at perioperation based on concept of enhanced recovery after surgery(ERAS) in the patients undergoing day surgery in a Chinese level Ⅱ hospital of peacekeeper Unit. Methods A total of 46 patients in the hospital scheduled for day surgery between May and December 2017 were randomized into ERAS group(n=23) and control group(n=23). The time for preoperative fasting and water deprivation,rigor after surgery,(NRS)numeric rating scale on postoperative pain,as well as postoperative nausea or vomiting,and early ambulation time;satisfaction degree of the patients and prolonged hospital stay rate were analyzed between the two groups. Results The time of preoperative fasting and water deprivation in the ERAS group was shorter than in control group;VAS scores during hours 2 and 4 after surgery in the ERAS group were significantly lower than those in the control group(all,P<0.05);but VAS score of 8 h was not significantly different between the two groups(P>0.05). In addition,early postoperative ambulation time and patient's satisfaction with nursing care in the ERAS group were all significantly better than those in control group(P<0.05). However,postoperative nausea,vomiting and prolonged hospital stay rate in ERAS group had no significantly difference than those in control group(P>0.05). Conclusion ERAS nursing intervention model can effectively reduce postoperative complications and increase patient's satisfaction with nursing care in Chinese level II hospital of peacekeeper unit.
引文
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