加速康复外科理念在子宫肌瘤腹腔镜围手术期护理的应用研究

Application Study of Accelerated Rehabilitation Surgery in Laparoscopic Perioperative Nursing of Uterine Fibroids

目的应用加速康复外科理念(ERAS)在子宫肌瘤腹腔镜手术围手术期进行护理干预,观察对患者术后康复的影响。方法选择该院2016年3月—2018年3月子宫肌瘤患者120例,两组各60例,随机分为对照组和研究组,对照组患者进行传统常规护理,研究组患者进行ERAS护理干预。记录患者相关临床恢复时间、并发症及住院费用。结果研究组患者首次下床活动时间、首次排气时间、排便时间、正常进食时间和住院时间分别为(12.45±2.71)h、(18.29±3.07)h、(9.89±0.30)h、(20.40±3.74)h和(6.14±0.71)d,均低于对照组(14.70±2.63)h、(21.33±3.15)h、(9.32±0.29)h、(23.19±3.82)h和(7.82±0.76)d,差异有统计学意义(u=9.84,10.33,9.41,11.05,8.96,P<0.05)。研究组患者依从性、满意度分别为(97.92±5.70)分和(98.76±4.08)分、均高于对照组(92.47±5.33)分和(93.29±3.41)分,差异有统计学意义(u=12.57,13.06,P<0.05),研究组并发症总发生率和住院费用分别为3.33%(2/60)和(9 520.38±224.61)元,均低于对照组11.67%(7/60)和(12 463.75±253.40)元,差异有统计学意义(χ~2=9.19,u=14.28,P<0.05)。结论 ERAS运用于妇科子宫肌瘤腹腔镜手术围手术期护理干预安全有效,能够促进患者术后康复,提高护理依从性和满意度,减少术后并发症的发生和住院费用。

Objective To apply the accelerated rehabilitation surgery concept(ERAS)in the perioperative period of uterine fibroid laparoscopic surgery to observe the effect of postoperative rehabilitation.Methods A total of 120 patients with uterine fibroids from March 2016 to March 2018 were enrolled.The patients were randomly divided into the control group and the study group.The patients in the control group underwent traditional routine nursing.The patients in the study group underwent ERAS nursing intervention.Patient-related clinical recovery time,complications,and hospitalization costs were recorded.Results The time of first bed-out activity,first-time exhaust time,defecation time,normal eating time and hospitalization time of the study group were(12.45±2.71)h,(18.29±3.07)h,(9.89±0.30)h,(20.40±3.74)h and(6.14±0.71)d were lower than the control group(14.70±2.63)h,(21.33±3.15)h,(9.32±0.29)h,(23.19±3.82)h and(7.82±0.76)d.The difference was statistically significant(u=9.84,10.33,9.41,11.05,8.96,P<0.05).The compliance and satisfaction of the study group were(97.92±5.70)points and(98.76±4.08)points,respectively,which were higher than the control group(92.47±5.33)points and(93.29±3.41)points,the difference was statistically significant(u=12.57,13.06,P<0.05),the total incidence of complications and hospitalization costs in the study group were 3.33%(2/60)and(9 520.38±224.61),respectively,which were lower than the control group 11.67%(7/60)and(12 463.75±253.40)yuan,the difference was statistically significant(χ^2=9.19,u=14.28,P<0.05).Conclusion The perioperative nursing intervention of ERAS in gynecological uterine fibroids is safe and effective,which can promote postoperative rehabilitation,improve nursing compliance and satisfaction,and reduce postoperative complications and hospitalization costs.