加速康复外科理念在功能性内镜鼻窦手术围手术期中的应用

Application of accelerated rehabilitation surgery in perioperative period of functional endoscopic sinus surgery

目的探讨加速康复外科理念在功能性内镜鼻窦手术围手术期中的应用价值。方法选择2018年1月至2019年3月期间广州中医药大学顺德医院耳鼻喉科收治的64例慢性鼻-鼻窦炎(CRS)患者为研究对象,均采用功能性内镜鼻窦手术治疗,根据随机数表法将其分为对照组和观察组各32例,对照组围手术期采用常规干预,观察组则在加速康复外科理念指导下进行干预。术后使用视觉模拟评分法(VAS)评估患者疼痛及睡眠情况,比较两组患者的住院时间,并在出院时进行满意度评分。结果观察组患者术后当天、术后1 d疼痛和睡眠VAS评分分别为(2.05±0.78)分、(1.25±0.31)分和(2.08±0.82)分、(3.28±1.13)分,均明显低于对照组的(4.26±1.35)分、(3.75±1.52)分和(4.32±1.49)分、(6.18±2.64)分,差异均有统计学意义(P<0.05);观察组患者的住院时间为(3.29±1.62)d,满意度评分为(92.28±7.58)分,与对照组的(5.37±2.09)d、(86.27±12.39)分比较差异均有统计学意义(P<0.05)。结论加速康复外科理念应用于功能性内镜鼻窦手术围手术期可以有效改善患者的术后舒适度,促进患者的术后康复、缩短住院时间,提高患者的满意度。

Objective To explore the application value of the concept of accelerated rehabilitation surgery in the perioperative period of functional endoscopic sinus surgery.Methods Sixty-four patients with chronic rhinosinusitis treated in Department of Otolaryngology,Shunde Hospital,Guangzhou University of Traditional Chinese Medicine from January 2018 to March 2019 were selected as the research objects.All patients were treated with functional endoscopic sinus surgery.They were divided into control group and observation group by random number table method,with 32 cases in each group.The control group was given routine interventions during perioperative period,while the observation group was given interventions guided by the concept of accelerated rehabilitation surgery.Visual analogue scale(VAS)was used to evaluate the pain and sleep status of patients after operation.The hospitalization time was compared between the two groups,and the satisfaction score at discharge were evaluated.Results The VAS scores of pain and sleep in the observation group were 2.05±0.78,2.08±0.82 on the day of operation,and 1.25±0.31,3.28±1.13 on the day after operation,respectively,which were significantly lower than 4.26±1.35,4.32±1.49,3.75±1.52,6.18±2.64 in the control group.The hospitalization time in the observation group was(3.29±1.62)d,and satisfaction score was 92.28±7.58,as compared with(5.37±2.09)d and 86.27±12.39 in the control group(P<0.05).Conclusion The application of accelerated rehabilitation surgery concept in functional endoscopic sinus surgery during perioperative period can effectively improve the postoperative comfort of patients,promote the recovery of patients,shorten the hospital stay,and improve patient satisfaction.