基于ERAS策略的综合干预在基层专科医院妇科腹腔镜手术中的应用

The effect of comprehensive intervention based on ERAS strategy in gynecological laparoscopic surgery in primary specialized hospitals

目的研究基于快速康复外科(ERAS)策略的综合干预在基层专科医院妇科腹腔镜手术中的应用效果。方法选取2017年4月至2019年4月深圳市南山区妇幼保健院收治的妇科腹腔镜手术患者82例。将所有受试者按照随机数字法分为观察组及常规组,各41例。常规组实施常规康复护理,观察组则实施基于ERAS策略的综合干预。比较两组各项恢复指标、术后并发症发生情况、自我效能感以及自尊水平。结果观察组的肛门恢复排气、自主下床活动以及住院时间均显著短于常规组,差异有统计学意义(均P<0.05)。在术后并发症发生率方面比较,观察组低于常规组,差异有统计学意义(P<0.05)。观察组及常规组干预后一般自我效能感量表评分(GSES)均提高,且观察组显著高于常规组,差异有统计学意义(P<0.05)。观察组及常规组干预后罗森伯格(Rosenberg)自尊量表评分显著提高,且观察组显著高于常规组,差异有统计学意义(P<0.05)。结论基于ERAS策略的综合干预可显著促进基层专科医院妇科腹腔镜手术患者的早日康复,降低术后并发症发生风险,提高患者的自我效能感以及自尊水平。

Objective To study the effect of comprehensive intervention based on the enhanced recovery after surgery(ERAS)on the application of gynecological laparoscopic surgery in primary specialized hospitals.Methods From April 2017 to April 2019,82 cases of gynecological patients undergoing laparoscopic surgery in this hospital were selected.All subjects were divided into observation group and conventional group according to random number method,with 41 cases in each group.The conventional group received routine rehabilitation nursing,while the observation group received comprehensive intervention based on ERAS strategy.The two groups were compared on various recovery indicators,postoperative complications,self-efficacy and self-esteem.Results The recovery of anal exhaust,spontaneous out-of-bed activity and hospital stay in the observation group were significantly shorter than those in the conventional group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than the conventional group,and the difference was statistically significant(P<0.05).After intervention,the scores of general self-efficacy scale(GSES)in both groups were improved,and the observation group was significantly higher than the conventional group,the difference was statistically significant(P<0.05).The Rosenberg self-esteem scale scores of the observation group and the conventional group were significantly improved after intervention,and the observation group was significantly higher than the conventional group,and the difference was statistically significant(P<0.05).Conclusions The comprehensive intervention based on ERAS strategy can significantly promote the early recovery of gynecological laparoscopic surgery patients in primary specialized hospitals,reduce the risk of postoperative complications,and improve patients'self-efficacy and self-esteem.