基于快速康复外科理念的手术护理在经鼻蝶入路垂体瘤切除术中的应用

Application of nursing interventions based on fast-track surgery in endoscopic endonasal transsphenoidal surgery for pituitary adenomas

目的探讨基于快速康复外科理念的手术护理在经鼻蝶入路垂体瘤切除术中的应用效果。方法 96例接受经鼻蝶入路垂体瘤切除术的患者随机分成对照组和研究组,各48例。对照组实施常规护理,研究组实施基于快速康复外科理念的手术护理干预。观察2组手术相关指标、护理满意率、并发症发生率及监护效果。结果研究组入住监护室时间和术后住院时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05或P<0.01)。研究组监护期护理不良事件及入住监护室后患者出现不良情绪的发生率低于对照组,研究组患者对护理计划知晓率高于对照组,差异有统计学意义(P<0.05)。研究组患者一过性尿崩和术后早期发热的发生率低于对照组,差异有统计学意义(P<0.05)。研究组总满意率97.92%(47/48),高于对照组的78.33%(34/48),差异有统计学意义(P<0.05)。结论对经鼻蝶入路垂体瘤切除术患者实施基于快速康复外科理念的手术护理干预,对降低术后并发症风险、促进术后康复具有积极意义。

Objective To investigate the effect of nursing interventions based on fast-track surgery in endoscopic endonasal transsphenoidal surgery for pituitary adenomas. Methods A total of 96 patient undergoing endoscopic endonasal transsphenoidal surgery were randomly divided into the control group and the study group, with 48 cases in each group. The control group was given routine nursing care, and the study group was applied with nursing interventions based on fast-track surgery.The surgical indicators, nursing satisfaction rate, incidence of complications and intensive care efficacy were observed and compared between two groups. Results The ICU and hospital length of stay was shorter in the study group than that of controls （P 〈0.05 or P 〈0.01）, the hospitalization costs was lower in the study group than that of controls （P 〈0. 01） . Patients in the study group had lower rate of adverse events, lower incidence of negative emotions, higher disease awareness compared with those in the control group （ P 〈 0. 05 ） . The incidence of transient diabetes insipidus and fever at early stage of post-operation was lower in the study group than that of controls （P 〈0. 05） . the overall nursing satis-faction rate was 97. 9 2 % （47/48） in the study group and was 78. 3 3 % （34/48 ） in the control group, with a significant difference （ P 〈 0. 05 ） . Conclusion Nursing interventions based on fast-track sur-gery is potentially effective to improve the rehabilitation of patients after endoscopic endonasal transs-phenoidal surgery for pituitary adenomas.