加速康复外科理念围手术期护理在宫颈癌根治术患者术后康复中的应用

Application of perioperative nursing based on the concept of enhanced recovery after surgery in the postoperative rehabilitation of patients with cervical cancer after radical hysterectomy

目的探讨加速康复外科(ERAS)理念围手术期护理在宫颈癌根治术患者术后康复中的应用。方法选取2017年12月至2020年4月九江市第三人民医院收治的64例宫颈癌根治术患者作为研究对象,采用随机数字表法将其分为对照组与试验组,各32例。对照组行常规护理干预,试验组行ERAS理念围手术期护理干预。比较两组患者应激反应、T淋巴细胞水平和术后恢复指标(术后首次排气、下床活动等)。结果试验组患者术后下床活动时间、首次排气时间、排便时间及术后住院天数均短于对照组,差异有统计学意义(P<0.05)。试验组患者在术后拔管10、15 min的收缩压、舒张压、平均动脉压、心率指标均低于对照组,差异有统计学意义(P<0.05)。试验组患者在术后1、2 d的CD3+、CD4+及CD3+/CD8+指标均高于对照组,差异有统计学意义(P<0.05);两组患者在术后1、2 d的CD3+、CD4+、CD8+及CD3+/CD8+指标均低于本组术毕时,差异有统计学意义(P<0.05)。结论宫颈癌根治术患者临床护理中应用ERAS理念围手术期护理干预,可减少术后疼痛及并发症,促使患者早日康复,早日回归家庭与工作。

Objective To explore the application of perioperative nursing based on the concept of enhanced recovery after surgery(ERAS)in the postoperative rehabilitation of patients with cervical cancer after radical hysterectomy.Methods Sixty-four cervical cancer patients undergoing radical hysterectomy admitted to Third People′s Hospital of Jiujiang City from December 2017 to April 2020 were selected as the research objects,they were divided into control group and experimental group according to random number table method,with 32 cases in each group.The control group received routine nursing intervention,and the experimental group received perioperative nursing intervention based on ERAS concept.The stress response,T lymphocyte levels and postoperative recovery indicators(first exhaust after operation,postoperative ambulation,etc)were compared between the two groups.Results The postoperative ambulation time,first exhaust time,defecation time and postoperative hospital stay in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The systolic blood pressure,diastolic blood pressure,mean arterial pressure and heart rate indexes of the experimental group were lower than those of the control group at 10 and 15 minutes after extubation,the differences were statistically significant(P<0.05).The CD3+,CD4+and CD3+/CD8+indexes of the experimental group were higher than those of the control group at 1 and 2 d after operation,the differences were statistically significant(P<0.05).The indexes of CD3+,CD4+and CD3+/CD8+in the two groups at 1 and 2 d after operation were lower than those at the end of operation,the differences were statistically significant(P<0.05).Conclusion The application of ERAS concept in the perioperative nursing of patients with cervical cancer after radical hysterectomy can reduce postoperative pain and complications,impel patients to recover and return to family and work as soon as possible.