基于ERAS理念的多学科协作对Stanford A型主动脉夹层患者I期心脏康复的应用效果研究

Application Effect of Multidisciplinary Collaboration Based on ERAS Concept on Stage I Cardiac Rehabilitation of Stanford Type A Aortic Dissection Patients

目的探讨基于加速康复外科(ERAS)理念的多学科协作对Stanford A型主动脉夹层患者心脏康复的应用效果研究。方法选取河南省胸科医院在2021年1月至2022年11月期间收治的80例Stanford A型主动脉夹层患者,随机分为对照组及观察组,各40例。观察组采用基于ERAS理念的多学科协作护理,对照组予以常规护理。比较两组患者围手术期指标、心功能、心理状况、疼痛评分以及生活质量水平。结果观察组的气管插管时间、ICU停留时间、术后住院时间、下床活动时间短于对照组,差异有统计学意义(P<0.05)。护理前,两组患者的心功能水平比较,差异无统计学意义(P>0.05);护理后,两组患者心功能水平均优于护理前,且观察组心功能优于对照组,差异有统计学意义(P<0.05)。护理前,两组心理状态与疼痛程度比较,差异无统计学意义(P>0.05);护理后,两组患者心理状态及疼痛程度均有所改善,且观察组改善程度优于对照组,差异有统计学意义(P<0.05)。护理前,两组生活质量评分比较,差异无统计学意义(P>0.05);护理后,两组患者生活质量水平均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论基于ERAS理念的多学科协作方案可改善Stanford A型主动脉夹层手术患者心功能,缓解患者不良情绪及疼痛程度,提高患者生活质量,缩短住院时间,可促进患者术后恢复。

Objective To investigate the effect of multidisciplinary collaboration based on the concept of enhanced recovery after surgery(ERAS)on cardiac rehabilitation of Stanford Type A aortic dissection patients.Methods A total of 80 Stanford type A aortic dissection patients admitted to Henan Chest Hospital from January 2021 to November 2022 were randomly divided into a control group and an observation group,with 40 cases in each group.The observation group received multidisciplinary collaborative nursing based on the ERAS concept,while the control group received routine nursing.Perioperative indexes,heart function,psychological status,pain score,and quality of life were compared between the two groups.Results The tracheal intubation time,ICU stay time,postoperative hospitalization time,and getting out of bedtime in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before nursing,there was no significant difference in cardiac function between the two groups(P>0.05).After nursing,the level of cardiac function in both groups was better than before nursing,and the observation group was better than the control group,the difference was statistically significant(P<0.05).Before nursing,there was no significant difference in mental state and pain degree between the two groups(P>0.05).After nursing,the psychological state and pain degree of patients in both groups were improved,and the improvement degree of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).Before nursing,there was no significant difference in mental state and pain degree between the two groups(P>0.05).After nursing,the psychological state and pain degree of patients in both groups were improved,and the improvement degree of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).Before nursing,there was no significant difference in quality of life scores between the two groups(P>0.05).After nursing,the quality of life of patients in both groups increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion The multidisciplinary collaborative program based on ERAS can improve the cardiac function of Stanford Type A aortic dissection patients,relieve the adverse mood and pain degree of patients,improve the quality of life of patients,shorten the length of hospital stay,and promote the postoperative recovery of patients.