围手术期加速康复外科护理对脑胶质瘤患者应激反应、术后恢复进程及心理状态的影响

Effect of perioperative enhanced recovery after surgery nursing on the stress response,postoperative recovery process,and psychological state of patients with glioma

目的探讨围手术期加速康复外科(ERAS)护理对脑胶质瘤患者应激反应、术后恢复进程及心理状态的影响。方法采用随机数字表法将92例接受手术治疗的脑胶质瘤患者分为观察组和对照组,每组46例,对照组患者围手术期采用常规外科护理,观察组患者围手术期采用ERAS护理,两组患者均干预至出院。比较术前、插管时、术毕两组患者的收缩压(SBP)和心率,比较术前、术后1天、术后3天两组患者的皮质醇(Cor)、白细胞介素-6(IL-6)水平,比较两组患者的术中指标及术后恢复情况,比较干预前后两组患者的焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分。结果插管时和术毕,两组患者的SBP、心率均高于本组术前,且观察组患者的SBP、心率均低于同时间点对照组,差异均有统计学意义(P﹤0.05)。术后1天和术后3天,两组患者的Cor、IL-6水平均高于本组术前,且观察组患者的Cor、IL-6水平均低于同时间点对照组,差异均有统计学意义(P﹤0.05)。观察组患者的手术时间、麻醉时间、术后恢复进食时间、首次下床活动时间、尿管拔除时间及术后住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者的SAS、SDS评分均低于本组干预前,且观察组患者的SAS、SDS评分均低于对照组,差异均有统计学意义(P﹤0.05)。结论围手术期ERAS护理可有效减轻脑胶质瘤患者的应激反应,加快患者术后恢复并改善其负性情绪。

Objective To investigate the effect of perioperative enhanced recovery after surgery(ERAS)nursing on the stress response,postoperative recovery process,and psychological state of patients with glioma.Method A total of92 glioma patients who received surgical treatment were divided into observation group and control group by the random number table method,with 46 cases in each group.The patients in the control group received routine surgical care during the perioperative period,while the patients in the observation group received ERAS nursing during the perioperative period.The duration of nursing in both groups lasted until discharge.The systolic blood pressure(SBP)and heart rate were compared between the two groups before operation,at the time of intubation,and after operation.The levels of cortisol(Cor)and interleukin-6(IL-6)were compared between the two groups before surgery,1 day after surgery,and 3 days after surgery.The intraoperative indicators and postoperative recovery of the two groups were compared,and the self-rating anxiety scale(SAS)scores and the self-rating depression scale(SDS)scores of the two groups before and after the intervention were also compared.Result At the time of intubation and after operation,the SBP and heart rate of the two groups were higher than those before operation,and the SBP and heart rate of the observation group were lower than those of the control group at the same time point,the differences were statistically significant(P<0.05).At 1 day and 3days after operation,the levels of Cor and IL-6 in the two groups were higher than those before operation,and the levels of Cor and IL-6 in the observation group were lower than those of the control group at the same time point,the differences were statistically significant(P<0.05).The operation time,anesthesia time,postoperative eating time,first ambulation time,urinary catheter removal time,and postoperative hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss volume was less than that of the control group,the differences were statistically significant(P<0.01).After the intervention,the SAS and SDS scores of the two groups were lower than those before the intervention,and the SAS and SDS scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion Employment of perioperative ERAS nursing could effectively reduce the stress response of glioma patients.Such intervention could speed up patients’postoperative recovery and improve their negative emotions.