加速康复外科术前宣教及其质量控制在结直肠手术中的应用

Application of preoperative education and quality control of enhanced recovery after surgery in colorectal surgery

目的研究加速康复外科(ERAS)术前宣教方案在结直肠手术中应用的可行性和有效性。方法选取中国人民解放军南部战区总医院2017年6月至2020年12月拟行择期腹腔镜结直肠手术157例,随机分为干预组(79例,采用质量控制干预下的ERAS术前宣教模式),对照组(78例,采用传统宣教方案),比较两组患者的围手术期整体满意度、术后首次下床活动时间、首次进流食时间、术后并发症发生率及术后平均住院时间。结果两组患者临床资料具有可比性,干预组的围手术期整体满意度明显高于对照组(P<0.05),首次下床活动时间及首次进流食时间显著早于对照组(P<0.05),但在术后并发症发生率和术后平均住院时间上与对照组无显著差异(P>0.05)。结论在质量控制干预下的ERAS术前宣教方案可充分保证宣教的效果和质量,有助于术前宣教方案的规范化、标准化和同质化。

Objective To investigate the feasibility and validity of preoperative education under quality control in enhanced recovery after surgery(ERAS)for patients undergoing colorectal surgery.Method Between June 2017 and December 2020,157 patients undergoing elective laparoscopic resection for colorectal cancer were enrolled and randomize into two groups.The intervention group(79 cases)adopted preoperative education under quality control,whereas the routine preoperative education was implemented in the control group(78 cases).The degree of satisfaction,the first ambulation time and liquid intake time,postoperative complications and mean postoperative hospital stay were compared between two groups with retrospective cohort study method.Result The clinical data of two groups were comparable.Degree of satisfaction in the intervention group patients was significantly higher than that in the control group(P<0.05),the first ambulation time and liquid intake time were statistically less than that in the control group(P<0.05),but there is no significant differences between two groups about the postoperative complications and mean postoperative hospital stay(P>0.05).Conclusion The quality and effect of preoperative education can be ensured by the project under quality control,and then,the normalization,standardization and homogenization of preoperative education may be realized by this way.