ERAS联合健康教育对脊髓损伤全身麻醉患者术后机体功能恢复的影响

Effect of ERAS combined with health education on recovery of body function in patients with spinal cord injury undergoing general anesthesia

目的探究加速康复外科(ERAS)联合健康教育对脊髓损伤全身麻醉(简称“全麻”)患者术后机体功能恢复的影响。方法选择2019年3月至2021年2月我院收治的60例脊髓损伤行全麻手术患者为研究对象,随机将其分为对照组和试验组,各30例。对照组实施常规护理干预,试验组在对照组的基础上增加ERAS联合健康教育干预。比较两组患者的康复指标(术后首次下床活动时间、术后伤椎前缘高度、术后愈合时间和住院时间)、运动功能、神经功能、认知功能以及术后并发症发生情况。结果试验组的术后首次下床活动时间、术后伤椎前缘高度比、术后愈合时间和住院时间均优于对照组,差异具有统计学意义(P<0.05)。干预6个月后,试验组的Fugl-Meyer下肢运动功能及Fugl-Meyer平衡功能评分均高于对照组,差异具有统计学意义(P<0.05)。干预6个月后,试验组的美国国立卫生院卒中量表(NIHSS)评分低于对照组,简易精神状态量表(MMSE)评分高于对照组,差异具有统计学意义(P<0.05)。试验组的并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论ERAS联合健康教育能够显著促进脊髓损伤全麻术后患者机体功能恢复,降低全麻对自我认知及神经功能的影响,值得临床推广。

Objective To investigate the effect of enhanced recovery after surgery(ERAS)combined with health education on recovery of body function in patients with spinal cord injury undergoing general anesthesia.Methods A total of 60 patients with spinal cord injury who underwent general anesthesia in our hospital from March 2019 to February 2021 were selected as the research objects and randomly divided into control group and experimental group,with 30 cases in each group.The control group received routine nursing intervention,and the experimental group added ERAS combined with health education intervention on the basis of the control group.The recovery indicators(time of first activity out of bed after operation,anterior height of the injured vertebra after operation,healing time after operation and hospital stay),motor function,neurological function,cognitive function and postoperative complications were compared between the two groups.Results The time of first activity out of bed after operation,anterior height ratio of the injured vertebra after operation,healing time after operation and hospital stay of the experimental group were better than those of the control group,and the differences were statistically significant(P<0.05).After 6 months of intervention,the scores of Fugl-Meyer lower limb motor function and Fugl-Meyer balance function in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).After 6 months of intervention,the National Institutes of Health Stroke Scale(NIHSS)score of the experimental group was lower than that of the control group,the Mini-Mental State Exam(MMSE)score was higher than that of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion ERAS combined with health education can significantly promote the recovery of body function in patients with spinal cord injury undergoing general anesthesia,and reduce the impact of general anesthesia on self-cognition and neurological function,which is worthy of clinical application.