基于循证的加速康复外科护理在脊柱侧凸围术期患者中的应用

Application of evidence recovery after surgery nursing in patients with scoliosis during perioperative period

目的探讨基于循证的加速康复外科(ERAS)护理在脊柱侧凸围术期患者中的应用效果。方法前瞻选取2019年1月至2020年6月上海交通大学医学院附属新华医院接受手术治疗的74例脊柱侧凸患者,采用随机数字表法分为对照组和观察组,各37例。对照组采用常规ERAS护理,观察组采用基于循证的ERAS护理。比较两组术后恢复相关指标;采用视觉模拟评分法(VAS)评估两组术后6、12、24 h和48 h疼痛程度;比较两组术后住院期间的并发症发生情况。结果观察组引流量、引流管移除、首次肛门排气及术后住院等时间低于对照组,差异有统计学意义(P<0.05)。两组不同时间点VAS评分组间、时间及交互作用比较,差异有统计学意义(P<0.05)。两组术后12、24、48 h的VAS评分均低于术后6 h,且观察组各时点VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论为脊柱侧凸患者围术期实施基于循证的ERAS护理干预,更利于促进患者术后恢复、减轻术后疼痛程度。

Objective To explore the effect of evidence recovery after surgery(ERAS)nursing in patients with scoliosis during perioperative period.Methods A prospective selection of 74 patients with scoliosis who underwent surgical treatment at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to June 2020 were divided into control group and observation group by random number table method,with 37 cases in each group.The control group used conventional ERAS nursing,and the observation group used evidence-based ERAS nursing.The related indicators of postoperative recovery were compared between the two groups;the visual analogue scoring method(VAS)was used to assess the pain levels of the two groups at 6,12,24 h and 48 h after surgery;the incidence of complications during the postoperative hospital stay was compared between the two groups.Results The time of drainage,drainage tube removal,first anal exhaust and postoperative hospitalization in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The difference between the two groups in VAS scores at different time points,time and interaction between groups were statistically significant(P<0.05).The VAS scores of the two groups at 12,24 h,and 48 h after surgery were lower than that at 6 h after surgery,and the VAS scores of the observation group were lower than those of the control group at all time points,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion The implementation of evidence-based ERAS nursing intervention for scoliosis patients during perioperative period is more conducive to promote postoperative recovery and reduce postoperative pain of patients than conventional ERAS nursing.