快速康复外科护理对重度脊柱侧凸行后路矫正术患者的干预效果观察

Observation on the Intervention Effect of Fast Track Surgery Nursing on Patients with Severe Scoliosis Undergoing Posterior Correction Surgery

目的:探讨快速康复外科护理应用于重度脊柱侧凸行后路矫正术患者中的干预效果。方法:选取2020年3月—2021年3月郑州市骨科医院收治的90例重度脊柱侧凸患者作为研究对象,按随机数表法分为对照组和观察组,每组各45例。两组患者均行后路矫正术,对照组采用常规围术期护理干预,观察组采用快速康复外科护理干预。两组患者均干预1个月。比较两组患者术后相关指标;干预第1 d、第4 d、第7 d、第10 d后的视觉模拟评分法(VAS)评分;干预前及干预第10 d后的焦虑自我评价量表(SAS)、抑郁自我评价量表(SDS)、健康相关生命质量量表(HRQOL)评分;干预期间不良反应发生情况。结果:两组患者手术时间与术中出血量比较,差异无统计学意义(t=0.651、0.832,P>0.05);观察组患者术后首次肛门排气时间、术后首次排便时间、术后首次下床时间均短于对照组,差异有统计学意义(t=6.028、7.932、10.220,P<0.05)。两组患者干预1~10 d后的VAS评分均逐渐降低,且观察组干预第1 d、第4 d、第7 d后的VAS评分均较对照组低,差异有统计学意义(t=7.030、8.520、3.278,P<0.05);两组患者干预10 d后VAS评分比较,差异无统计学意义(t=1.453,P>0.05)。两组患者干预10 d后的SAS、SDS、HRQOL评分较干预前均降低,且观察组较对照组更低,差异有统计学意义(t=2.790、2.210、2.724,P<0.05)。观察组患者干预期间各项不良反应发生率较对照组低,差异有统计学意义(χ^(2)=4.865、7.788,P<0.05)。结论:快速康复外科护理可明显缩短重度脊柱侧凸行后路矫正术患者术后恢复时间,减少不良反应发生,降低疼痛感,同时可缓解患者不良情绪,提高术后生命质量。

Objective: To investigate the intervention effect of fast recovery surgical nursing in patients with severe scoliosis undergoing posterior correction. Methods: A total of 90 patients with severe scoliosis who were admitted to the hospital from March 2020 to March 2021 were selected as the research objects, and divided into the control group and the observation group according to the random number table method, with 45 cases in each group. Both groups received posterior correction surgery, the control group received routine perioperative nursing intervention, and the observation group received rapid rehabilitation surgery nursing intervention. The patients in both groups were treated for 1 month. The postoperative related indicators were compared between the two groups, including the visual analogue scale(VAS) score on the 1st, 4th, 7th, and 10th d of the intervention, the Self-rating anxiety scale(SAS), self-rating depression scale(SDS), health-related quality of life scale(HRQOL) scores before and after the intervention on the 10th d and the occurrence of adverse reactions during the intervention. Results: There was no statistically significant difference in the operation time and intraoperative blood loss between the two groups(t=0.651, 0.832, P>0.05). The time of the first anal exhaust, the time of the first defecation after the operation, and the first time to get out of bed after the operation of the observation group were shorter than those of the control group, and the differences were statistically significant(t=6.028, 7.932,10.220, P<0.05). The VAS scores of the two groups of patients were gradually decreased after 1-10 d of intervention, and the VAS scores of the observation group after 1 d, 4 d, and 7 d of intervention were lower than those of the control group, and the differences were statistically significant(t=7.030, 8.520, 3.278, P<0.05). There was no significant difference in VAS scores between the two groups after 10 d of intervention(t=1.453, P>0.05). After 10 days of intervention, the SAS, SDS, and HRQOL scores of the two groups were all lower than those before the intervention, and the observation group was lower than the control group, and the difference was statistically significant(t=2.790, 2.210, 2.724, P<0.05). The incidence of adverse reactions in the observation group during the intervention period was lower than that in the control group, and the difference was statistically significant(χ^(2)=4.865,7.788, P<0.05). Conclusion: Fast track surgery nursing can significantly shorten the postoperative recovery time of patients with severe scoliosis undergoing posterior correction, reduce the occurrence of adverse reactions, reduce pain, relieve patients’ negative emotions, and improve postoperative quality of life.