多学科协作加速康复外科护理在肾囊肿腹腔镜手术中的应用

Application of multidisciplinary cooperative accelerated rehabilitation surgical nursing in laparoscopic renal cyst surgery

目的探讨多学科协作模式下加速康复外科(ERAS)理念在肾囊肿腹腔镜手术患者围术期护理中的应用效果。方法选择2019年5月—2020年10月我院收治并行肾囊肿腹腔镜手术的患者68例,按随机数字表法分为两组,各34例。对照组实施常规护理,观察组在此基础上实施多学科协作模式下EARS理念指导的护理干预。比较两组术后康复指标、术后疼痛、满意度及并发症情况。结果观察组术后首次排气、首次下床、拔除尿管、拔除引流管、住院时间分别为(10.32±1.75)h、(1.63±0.58)d、(7.20±1.32)h、(12.07±2.66)h、(2.82±0.83)d,与对照组的(16.79±3.16)h、(2.79±0.46)d、(37.51±4.94)h、(51.36±10.87)h、(4.04±1.67)d比较,差异有统计学意义(t=10.444、9.137、34.564、20.472、3.787,P<0.001)。观察组术后24 h、48 h视觉模拟评分(VAS)评分分别为(4.25±1.34)分、(2.94±0.66)分,与对照组的(6.73±1.48)分、(3.85±0.72)分比较,差异有统计学意义(t=7.243、5.433,P<0.001)。观察组满意度为100%,与对照组的85.29%比较,差异有统计学意义(Z=2.953,P=0.003)。观察组并发症发生率为5.88%,与对照组的17.65%比较,差异无统计学意义(χ^(2)=1.275,P=0.259)。结论多学科协作模式下ERAS理念运用于肾囊肿腹腔镜手术患者围术期护理有助于加快术后康复进程,减轻疼痛,并提高护理满意度。

Objective To explore the application effect of enhanced recovery after surgery(ERAS) concept in the perioperative nursing of patients with renal cyst undergoing laparoscopic surgery under the mode of multidisciplinary cooperation.Methods A total of 68 patients with renal cysts undergoing laparoscopic surgery admitted to our hospital from May 2019 to October 2020 were selected and divided into a control group and an observation group according to the random number table method,with 34 cases in each group.The control group received the routine nursing,and the observation group received the nursing intervention guided by EARS concept under multidisciplinary cooperation mode on the basis of the control group.The indexes of postoperative rehabilitation,postoperative pain,satisfaction degree and complications were compared between the two groups.Results After the operation,the time of first exhaust,first getting out of bed,removing urinary catheter,removing drainage tube and hospitalization in the observation group was(10.32 ± 1.75) h,(1.63 ± 0.58) d,(7.20 ± 1.32) h,(12.07 ± 2.66) h and(2.82 ± 0.83) d,respectively,compared with(16.79 ± 3.16) h,(2.79 ± 0.46) d,(37.51 ±4.94) h,(51.36 ± 10.87) h and(4.04 ± 1.67) d in the control group,the differences were statistically significant(t = 10.444,9.137,34.564,20.472,3.787,P < 0.001).The visual analogue scale(VAS) scores of the observation group at 24 h and 48 h after the operation were(4.25 ± 1.34) and(2.94 ± 0.66) respectively,which were significantly different from those of the control group:(6.73 ± 1.48) and(3.85 ± 0.72)(t = 7.243,5.433,P < 0.001).The satisfaction rate of the observation group was100%,compared with 85.29% of the control group,the difference was statistically significant(z = 2.953,P = 0.003).The incidence of complications in the observation group was 5.88%,compared with 17.65% in the control group,the difference was not statistically significant χ^(2)= 1.275,P = 0.259).Conclusion Under the multidisciplinary cooperation mode,the application of ERAS concept in perioperative nursing of patients undergoing laparoscopic surgery for renal cyst is helpful to accelerate the process of postoperative rehabilitation,relieve pain,and improve nursing satisfaction.