加速康复外科理念对泌尿外科常见腹腔镜手术患者围手术期的护理效果

Perioperative Nursing Effect of Enhanced Recovery after Surgery Concept on Patients with Common Laparoscopic Surgery in Urology

目的探讨加速康复外科(ERAS)理念对泌尿外科常见腹腔镜手术患者围手术期的护理效果。方法选取2016年2月~2017年2月我院行腹腔镜手术患者206例作为研究对象,采用随机数字表法分为观察组和对照组,每组103例。对照组实施常规护理,观察组实施ERAS理念指导下的护理模式,比较两组术后24、72 h VAS评分、护理效果(肛门排气排便时间,下床活动时间、住院时间、住院费用)及并发症发生情况。结果观察组术后24、72 h VAS评分低于对照组,差异有统计学意义(P<0.05);观察组排气时间、下床活动时间、住院时间及住院费用均优于对照组[(21.90±3.43)h vs(39.77±5.73)h]、[(20.05±3.94)h vs(48.93±5.66)h]、[(3.80±0.72)d vs(5.75±0.90)d]、[(3.86±0.75)万元vs(6.44±0.40)万元],差异有统计学意义(P<0.05);观察组并发症发生率低于对照组(0.97%vs 15.53%),差异有统计学意义(P<0.05)。结论ERAS理念指导下的护理模式应用于泌尿科常见腹腔镜手术患者围手术期护理效果较好,可有效缓解患者术后疼痛、缩短患者排气时间、下床活动时间、住院时间,降低患者住院费用。

Objective To explore the nursing effect of enhanced recovery after surgery(ERAS)concept on patients undergoing laparoscopic surgery in urology.Methods From February 2016 to February 2017,206 patients who underwent laparoscopic surgery in our hospital were selected as the research objects,and the random number table method was used to divide them into observation group and control group,with 103 cases in each group.The control group received routine nursing,the observation group implemented nursing mode guided by the ERAS concept,and the 24 and 72 h postoperative VAS scores,nursing effects(anal exhaust defecation time,out of bed activity time,hospitalization time,hospitalization cost)of the two groups were compared and complications.Results The VAS scores in the observation group at 24 and 72 h after surgery were lower than those in the control group,the differences were statistically significant(P<0.05);the exhaust time,time to get out of bed,length of hospital stay,and hospitalization costs in the observation group were better than those in the control group[(21.90±3.43)h vs(39.77±5.73)h],[(20.05±3.94)h vs(48.93±5.66)h],[(3.80±0.72)d vs(5.75±0.90)d],[(3.86±0.75)million vs(6.44±0.40)million],the difference was statistically significant(P<0.05);the incidence of complications in the observation group was lower than that in the control group(0.97%vs 15.53%),the difference was statistical significance(P<0.05).Conclusion The nursing mode guided by the ERAS concept is effective in the perioperative nursing of patients with common laparoscopic surgery in urology.It can effectively alleviate postoperative pain,shorten patients'exhaust time,get out of bed,length of hospital stay,and reduce the hospitalization cost.