ERAS理念下围手术期精细化营养管理模式在剖宫产患者中的临床应用

Clinical Application of Perioperative Refined Nutrition Management Mode under ERAS Concept in Patients with Cesarean Section

目的:探讨加速康复外科(enhanced recovery after surgery,ERAS)理念下围手术期精细化营养管理模式在剖宫产患者中的实践效果。方法:选择2019年6月-2020年6月自贡市第一人民医院收治的400例剖宫产患者,根据时间顺序,2019年6-12月采用传统营养管理模式的200例产妇作为对照组,2020年1-6月采取ERAS理念下围手术期精细化营养管理模式的200例产妇作为试验组,观察两组围手术期口渴及饥饿情况、术后肠道功能恢复情况,项目组成员出院前对围手术期营养管理方案进行满意度调查。结果:试验组进入手术室时轻、中度口渴及术后首次自主进食前轻度饥饿发生率均低于对照组(P<0.05),但两组重度口渴及中重度饥饿发生率比较,差异均无统计学意义(P>0.05);试验组术后12 h内肠鸣音恢复、术后24 h内肛门首次排气、术后48 h内首次排便例数均多于对照组(P<0.05);试验组总满意度为100%,高于对照组的79.0%(P<0.05)。结论:剖宫产患者给予ERAS理念下围手术期精细化营养管理模式,可以加快围手术期胃肠道功能恢复,减少围手术期不适,提高患者满意度,促进患者早日康复。

Objective:To explore the practical effect of perioperative refined nutrition management mode under enhanced recovery after surgery(ERAS)concept in patients with cesarean section.Method:A total of 400 patients with cesarean section who admitted to Zigong First People’s Hospital from June 2019 to June 2020 were selected as subjects.According to the time sequence,200parturients who adopted the traditional nutritional management mode from June to December 2019 were taken as the control group,and 200 parturients who adopted perioperative refined nutrition management mode under ERAS concept from January to June 2020 were taken as the experimental group.The perioperative thirst and hunger,postoperative intestinal function recovery of two groups were observed,researchers conducted satisfaction survey on perioperative nutrition management program before discharge.Result:The incidence of mild/moderate thirst when entering the operating room and mild hunger before the first independent eating after operation in the experimental group were lower than those in the control group(P<0.05),but there were no significant differences in the incidence of mild hunger thirst and mild/moderate between two groups(P>0.05).The cases of recovery of bowel sounds within 12 h after operation,the first anal exhaust within 24 h after operation and the first defecation within 48 h after operation in the experimental group were more than those in the control group(P<0.05).The total satisfaction rate of the experimental group was 100%,which was higher than 79.0%of the control group(P<0.05).Conclusion:Perioperative refined nutrition management mode under ERAS concept for cesarean section patients can accelerate the recovery of gastrointestinal function,reduce perioperative discomfort,improve patient satisfaction and promote early recovery of patients.