基于循证及快速康复的活动方案在肝叶切除术后患者中的应用

Application of Program Based on Evidence and Enhanced Recovery after Surgery in Patients after Hepatectomy

目的:探讨基于循证及快速康复的活动方案在开腹肝切除术后患者中的应用效果。方法:将2017年7月1日~2018年7月31日接受开腹肝叶切除术的80例患者采用随机数字表法分为实验组和对照组各40例。实验组采用基于循证及快速康复的肝叶切除术后活动方案,对照组采用传统肝叶切除术后常规护理。比较两组胃肠功能恢复时间、并发症发生率、患者满意度等指标。结果:实验组术后首次肛门排气时间短于对照组(t=-2.023,P=0.046),胃管留置时间短于对照组(t=-2.339,P=0.022),下肢深静脉血栓形成发生率低于对照组(χ^2=5.000,P=0.025),患者满意度高于对照组(χ^2=20.232,P<0.001)。结论:采用基于循证及快速康复构建的肝叶切除术后患者活动方案,可以促进患者胃肠功能恢复,降低下肢深静脉血栓形成的发生率,提高满意度,值得在临床上推广应用。

Objective:To investigate the effect of activity program based on evidence and enhanced recovery after surgery(ERAS)in patients after hepatectomy.Methods:A total of 80 patients who underwent open hepatectomy from July 1,2017 to July 31,2018 were divided into the experimental group and the control group by random number table method.The experimental group was treated with activity program based on evidence and ERAS,while the control group was treated with conventional post-hepatectomy care.The indexes of gastrointestinal function recovery time,complication rate and patient satisfaction were compared between the two groups.Results:The first postoperative anal exhaust time of the experimental group was shorter than that of the control group(t=-2.023,P=0.046),the indwelling time of the gastric tube was shorter than that of the control group(t=-2.339,P=0.022),the incidence of deep venous thrombosis of the lower extremity was lower than that of the control group(χ^2=5.000,P=0.025),and the patient satisfaction was higher than that of the control group(χ^2=20.232,P<0.001).Conclusion:The activity program of patients after hepatectomy based on evidence and ERAS can promote the recovery of patients′gastrointestinal function,reduce the incidence of lower extremity deep vein thrombosis,and improve satisfaction,which is worthy of clinical application.