加速康复外科策略在漯河县市级医院骨科护理中的应用现况

The current status of the enhanced recovery after surgery in the department of orthopaedics in hospitals in Luohe

目的了解加速康复外科策略在县市级医院骨科护理中的应用现况。方法采用自行设计的问卷,对漯河市县市级医院加速康复外科策略在骨科的应用现况进行调查。结果加速康复外科中各项策略在漯河地区县市级医院实施差的项目包括麻醉前准备、术前皮肤准备、预防出血中不常规使用止血带、术中保暖、无痛治疗、预防恶心呕吐;实施优的项目包括鼓励患者吹气球等提升心肺功能、预防感染、术后预防血栓、术后24 h拔除导尿管、不使用或术后48 h拔除引流管、尽早下床活动;其余策略为良。结论加速康复外科策略在县市级医院骨科护理中未完全落实,医护人员需结合地方患者特点加以实施,以促进患者康复,提高医疗效率。

Objective To investigate the status of the enhanced recovery after surgery(ERAS) in the department of Orthopaedics in hospitals in Luohe. Methods We conducted an investigation on application status of ERAS strategy in the department of orthopaedics in hospitals in Luohe. Results The items of ERAS which were not well implemented included the shortening the fasting time before anesthesia,cleaning skin before operation without shaving,unconventional utilization of tourniquet,keeping warm during operation,preemptive analgesia and multimodal analgesia,and actively preventing nausea and vomiting. Items that were implemented optimally included encouraging balloon blowing and other measures to improve cardiopulmonary function,prophylactic utilization of antibiotics before operation,prevention of thrombus after operation,not using utilization or removing the catheter 48 hours after operation,and early activity of getting out of bed. Conclusion The ERAS has not been fully implemented in the department of orthopaedics in hospitals of Luohe. Health professionals should implement it according to the characteristics of local patients so as to achieve the goals of promoting patients’ rehabilitation and improving medical efficiency.