加速康复外科理念对行乳腺癌根治术患者围手术期指标和社会功能的影响

Effect of enhanced recovery after surgery on perioperative indicators and social function of patients undergoing radical mastectomy

目的探讨基于加速康复外科(ERAS)理念的护理干预对行乳腺癌根治术患者围手术期指标和社会功能的影响。方法选取2018年9月至2020年8月于中山大学肿瘤防治中心乳腺科行乳腺癌根治术的98例患者,按照随机数字表法分为对照组(n=49)和观察组(n=49)。对照组患者采用常规护理干预,观察组患者采用基于ERAS理念的护理干预。比较两组患者的围手术期指标、上肢功能恢复情况和社会功能。结果观察组的创面愈合时间、引流时间和住院时间均显著短于对照组(P值均<0.05)。观察组的总引流量显著少于对照组(P<0.05)。观察组的上举功能达优率为73.47%,显著高于对照组的51.02%(P<0.05)。观察组的外展功能达优率为65.31%,显著高于对照组的44.90%(P<0.05)。术后7 d,两组的社会功能得分均显著高于同组术前(P值均<0.05),观察组显著低于对照组(P<0.05)。术后21 d,两组的社会功能得分均显著高于同组术前(P值均<0.05),但均显著低于同组术后7 d(P值均<0.05),观察组显著低于对照组(P<0.05)。结论基于ERAS理念的护理干预有助于改善行乳腺癌根治术患者的康复效果、上肢功能恢复情况和社会功能。

Objective To explore the impact of nursing intervention based on the concept of enhanced recovery after surgery(ERAS)on perioperative indicators and social function of patients undergoing radical mastectomy.Methods A total of 98 patients who underwent radical mastectomy from September 2018 to August 2020 in the Department of Breast Surgery at Sun Yat-sen University Cancer Center were randomly divided into a control group(n=49)and an observation group(n=49)by using a random number table.The patients in the control group were treated with routine nursing intervention,and the patients in the observation group were treated with nursing intervention based on ERAS concept.Perioperative indicators,upper limb function recovery and social function were compared between the two groups.Results The wound healing time,duration of drainage and length of hospital stay in the observation group were significantly shorter than those in the control group(all P<0.05).The total drainage volume in the observation group was significantly less than that in the control group(P<0.05).The excellent rate of lifting function in the observation group was 73.47%,which was significantly higher than 51.02%in the control group(P<0.05).The excellent rate of abduction function in the observation group was 65.31%,which was significantly higher than 44.90%in the control group(P<0.05).At 7 days after operation,the social function scores of the two groups were significantly higher than those before operation(both P<0.05),and the scores of the observation group were significantly lower than those of the control group(P<0.05).At 21 days after operation,the social function scores of the two groups were significantly higher than those of the same group before operation(both P<0.05),but significantly lower than those at 7 days of the same group after operation(both P<0.05),and the scores of the observation group were significantly lower than those of the control group(P<0.05).Conclusion Nursing intervention based on ERAS concept is helpful to improve the rehabilitation effect,upper limb function recovery and social function of patients undergoing radical mastectomy.