快速康复外科在颅内动脉瘤经弹簧圈栓塞术围术期的应用
摘要
目的探讨快速康复外科(FTS)在颅内动脉瘤经弹簧圈栓塞术围术期的应用。方法选取南昌大学第二附属医院神经外科2015年8月至2017年8月共计102例行颅内动脉瘤经弹簧圈栓塞术的患者,随机分为FTS组45例和传统护理组57例。分别按照FTS方案和传统护理方案进行围术期护理,比较2组患者术后并发症、格拉斯哥预后评分(GOS评分)、住院时间、自理能力及满意度。结果 (1)并发症:FTS组术后并发症3例,传统护理组术后并发症12例,FTS组并发症发生率较传统护理组低,差异具有统计学意义(P<0.05)。(2)患者GOS评分、住院时间:FTS组患者GOS(4.07±0.61)分较传统护理组GOS(3.82±0.72)分高,FTS组住院时间(9.32±1.69)d较传统护理组(10.82±1.92)d短,差异有统计学意义(P<0.05)。(3)自理能力及满意度:FTS组自理能力(78.00±14.62)分较传统护理组(70.25±16.88)分高,FTS组患者满意度(95.50±3.87)分较传统护理组(92.08±4.04)分高,差异均有统计学意义(P<0.01)。结论 FTS应用于颅内动脉瘤经弹簧圈栓塞术患者,能有效减少术后并发症,提高GOS评分,缩短住院时间,提升自理能力及满意度。
引文
[1]ETMINAN N,RINKEL GJ.Unruptured intracranial aneurysms:development,rupture and preventive management[J].Nat Rev Neurol,2016,12(12):699-713.
[2]ZHAO J,LIN H,SUMMERS R,et al.Current treatment strategies for intracranial aneurysms:an overview[J].Angiology,2018,69(1):17-30.
[3]BILLER J,GODERSKY J C,ADAMS HP J R.Management of aneurysmal subarachnoid hemorrhage[J].Stroke,1988,19(10):1300-1305.
[4]GRANT M C,YANG D J,WU C L,et al.Impact of enhanced recovery after surgery and fast track surgery pathways on healthcare-associated infections:results from a systematic review and meta-analysis[J].Ann Surg,2017,265(1):68-79.
[5]COOLSEN M M,WONG-LUN-HING E M,VAN DAMR M,et al.A systematic review of outcomes in patients undergoing liver surgery in an enhanced recovery after surgery pathways[J].HPB,2013,15(4):245-251.
[6]王超,孙超.颅内动脉瘤的研究进展[J].中华神经外科杂志,2017,33(8):859-862.
[7]GHOSH S,DEY S,MALTENFORT M,et al.Impact of Hunt-Hess grade on the glycemic status of aneurysmal subarachnoid hemorrhage patients[J].Neurol India,2012,60(3):283-287.
[8]卢洪流.中英对照GOS评分[J].中华神经医学杂志,2005,4(5):537.
[9]王海燕,刘秋鸣,储明子,等.Barthel指数分级护理与Orem自理模式联合在脑卒中偏瘫患者护理中的应用[J].护理研究,2016,30(31):3950-3952.
[10]FOTAKOPOULOS G,TSIANAKA E,FOUNTAS K,et al.Clipping versus coiling in anterior circulation ruptured intracranial aneurysms:a Meta-Analysis[J].World Neurosurg,2017,104:482-488.
[11]WILMORE DW,KEHLET H.Management of patients in fast track surgery[J].BMJ,2001,322(7284):473-476.
[12]朱诗白,翟洁,蒋超,等.膝关节置换围术期的快速康复措施[J].中国组织工程研究,2017,21(3):456-463.
[13]KIM T,LEE H,AHN S,et al.Incidence and risk factors of intracranial aneurysm:a national cohort study in Korea[J].Inter J Stroke,2016,11(suppl 1):S917-927.
[14]徐云,常莉,丁涟沭,等.颅内动脉瘤栓塞术后患者目标血压控制的护理干预[J].全科护理,2017,15(11):1330-1331.
[15]OKUMUS G,OZCELIK B,SASANI H,et al.Do appropriate thromboprophylaxis and routine physiotherapy prevent venous thromboembolism in intensive care unit?[J].Turk Gogus Kalp Dama,2015,23(1):92-97.
[16]吴满荣,温杏良,董丽娟,等.快速康复外科中西医结合护理预防股骨干骨折术后深静脉血栓形成[J].护理研究,2014(34):4277-4278.
[17]TOROSSIAN A,BRAUER A,HOCKER J,et al.Preventing inadvertent perioperative hypothermia[J].Dtsch Arztebl Int,2015,112(10):166-172.
[18]朱彩凤,马春平,周萍,等.快速康复外科在预防肺癌术后肺部感染的应用[J].护理实践与研究,2017,14(19):59-61.
[19]DONG Q,ZHANG K,CAO S,et al.Fast-track surgery versus conventional perioperative management of lung cancer-associated pneumonectomy:a randomized controlled clinical trial[J].World J Surg Oncol,2017,15(1):20.
[20]秦薇.择期手术患者术前禁食禁饮时间的研究进展[J].中华护理杂志,2014,49(1):76-79.
[21]BOLAND M R,REYNOLDS I,MCCAWLEY N,et al.Liberal perioperative fluid administration is an Independent risk factor for morbidity and is associated with longer hospital stay after rectal cancer surgery[J].Ann R Coll Surg Engl,2017,99(2):113-116.
[22]钱路创,沙洪存,洪晓明.快速康复外科在腹腔镜胃癌根治术的研究进展[J].中国微创外科杂志,2017,17(5):471-474.
[23]曲音音.快速康复外科理念下全膝关节置换术围术期镇痛进展[J].中国微创外科杂志,2016,16(2):172-176.
[24]MATTAROZZI K,BALDIN E,ZENESINI C,et al.Effect of organizational features on patient satisfaction with care in Italian multiple sclerosis centrese[J].European Journal of Neurology,2017,24(4):631-637.
[25]任秋平,罗艳丽.多学科合作快速康复外科模式在肝癌围术期的应用[J].华西医学,2017(3):400-403.
[2]ZHAO J,LIN H,SUMMERS R,et al.Current treatment strategies for intracranial aneurysms:an overview[J].Angiology,2018,69(1):17-30.
[3]BILLER J,GODERSKY J C,ADAMS HP J R.Management of aneurysmal subarachnoid hemorrhage[J].Stroke,1988,19(10):1300-1305.
[4]GRANT M C,YANG D J,WU C L,et al.Impact of enhanced recovery after surgery and fast track surgery pathways on healthcare-associated infections:results from a systematic review and meta-analysis[J].Ann Surg,2017,265(1):68-79.
[5]COOLSEN M M,WONG-LUN-HING E M,VAN DAMR M,et al.A systematic review of outcomes in patients undergoing liver surgery in an enhanced recovery after surgery pathways[J].HPB,2013,15(4):245-251.
[6]王超,孙超.颅内动脉瘤的研究进展[J].中华神经外科杂志,2017,33(8):859-862.
[7]GHOSH S,DEY S,MALTENFORT M,et al.Impact of Hunt-Hess grade on the glycemic status of aneurysmal subarachnoid hemorrhage patients[J].Neurol India,2012,60(3):283-287.
[8]卢洪流.中英对照GOS评分[J].中华神经医学杂志,2005,4(5):537.
[9]王海燕,刘秋鸣,储明子,等.Barthel指数分级护理与Orem自理模式联合在脑卒中偏瘫患者护理中的应用[J].护理研究,2016,30(31):3950-3952.
[10]FOTAKOPOULOS G,TSIANAKA E,FOUNTAS K,et al.Clipping versus coiling in anterior circulation ruptured intracranial aneurysms:a Meta-Analysis[J].World Neurosurg,2017,104:482-488.
[11]WILMORE DW,KEHLET H.Management of patients in fast track surgery[J].BMJ,2001,322(7284):473-476.
[12]朱诗白,翟洁,蒋超,等.膝关节置换围术期的快速康复措施[J].中国组织工程研究,2017,21(3):456-463.
[13]KIM T,LEE H,AHN S,et al.Incidence and risk factors of intracranial aneurysm:a national cohort study in Korea[J].Inter J Stroke,2016,11(suppl 1):S917-927.
[14]徐云,常莉,丁涟沭,等.颅内动脉瘤栓塞术后患者目标血压控制的护理干预[J].全科护理,2017,15(11):1330-1331.
[15]OKUMUS G,OZCELIK B,SASANI H,et al.Do appropriate thromboprophylaxis and routine physiotherapy prevent venous thromboembolism in intensive care unit?[J].Turk Gogus Kalp Dama,2015,23(1):92-97.
[16]吴满荣,温杏良,董丽娟,等.快速康复外科中西医结合护理预防股骨干骨折术后深静脉血栓形成[J].护理研究,2014(34):4277-4278.
[17]TOROSSIAN A,BRAUER A,HOCKER J,et al.Preventing inadvertent perioperative hypothermia[J].Dtsch Arztebl Int,2015,112(10):166-172.
[18]朱彩凤,马春平,周萍,等.快速康复外科在预防肺癌术后肺部感染的应用[J].护理实践与研究,2017,14(19):59-61.
[19]DONG Q,ZHANG K,CAO S,et al.Fast-track surgery versus conventional perioperative management of lung cancer-associated pneumonectomy:a randomized controlled clinical trial[J].World J Surg Oncol,2017,15(1):20.
[20]秦薇.择期手术患者术前禁食禁饮时间的研究进展[J].中华护理杂志,2014,49(1):76-79.
[21]BOLAND M R,REYNOLDS I,MCCAWLEY N,et al.Liberal perioperative fluid administration is an Independent risk factor for morbidity and is associated with longer hospital stay after rectal cancer surgery[J].Ann R Coll Surg Engl,2017,99(2):113-116.
[22]钱路创,沙洪存,洪晓明.快速康复外科在腹腔镜胃癌根治术的研究进展[J].中国微创外科杂志,2017,17(5):471-474.
[23]曲音音.快速康复外科理念下全膝关节置换术围术期镇痛进展[J].中国微创外科杂志,2016,16(2):172-176.
[24]MATTAROZZI K,BALDIN E,ZENESINI C,et al.Effect of organizational features on patient satisfaction with care in Italian multiple sclerosis centrese[J].European Journal of Neurology,2017,24(4):631-637.
[25]任秋平,罗艳丽.多学科合作快速康复外科模式在肝癌围术期的应用[J].华西医学,2017(3):400-403.