胆囊结石伴胆囊炎腹腔镜术后ERAS护理模式的应用效果

Application effect of enhanced recovery after surgery nursing model after laparoscopic surgery for gallstones with cholecystitis

目的探讨胆囊结石伴胆囊炎腹腔镜术后加速康复外科(ERAS)护理模式的应用效果。方法选取2021年1月至2022年2月安徽省安庆市第一人民医院行腹腔镜术治疗的80例胆囊结石伴胆囊炎患者,根据随机数字表法将其分成对照组和试验组,各40例。对照组予以常规护理模式,试验组予以ERAS护理模式。比较两组术后恢复情况、数字疼痛评分法(NRS)评分、Wong-Baker脸谱疼痛评分、健康状况调查简表(SF-36)评分、并发症总发生率及护理满意度。结果试验组进食、首次排气、首次排便、下床活动及出院时间短于对照组,差异有统计学意义(P<0.05)。整体分析发现,NRS、Wong-Baker脸谱疼痛评分的组间、时间点及交互作用比较差异有统计学意义(P<0.05)。进一步两两比较,组内比较:两组组内各时间点NRS、Wong-Baker脸谱疼痛评分比较,差异有统计学意义(P<0.05);组间比较:试验组术后4、12 h及24 h的NRS、Wong-Baker脸谱疼痛评分均低于对照组,差异有统计学意义(P<0.05)。试验组SF-36评分高于对照组,差异有统计学意义(P<0.05)。试验组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。试验组护理满意度优于对照组,差异有统计学意义(P<0.05)。结论腹腔镜术后实施ERAS护理模式对胆囊结石伴胆囊炎患者的效果显著,促进患者术后快速恢复,加快康复进程,有效缓解术后疼痛程度并减少并发症的发生,明显提高患者术后生活质量及其满意度。

Objective To explore the application effect of enhanced recovery after surgery(ERAS)nursing model after laparoscopic surgery for gallstones with cholecystitis.Methods A total of 80 patients with gallstones with cholecystitis who underwent laparoscopic treatment in Anqing First People’s Hospital of Anhui Province from January 2021 to February 2022 were selected,according to random number table method,the patients were divided into control group and experimental group,with 40 cases in each group.The control group was given conventional nursing mode,and the experimental group was given ERAS nursing mode.Postoperative recovery,numeric rating scales(NRS),Wong-Baker facial pain score,short form-36 of health survey(SF-36)score,complications and satisfaction with nursing were compared between the two groups.Results The feeding,first exhaust,first defecation,getting out of bed,and discharge time of experimental group were shorter than those of control group,and the differences were statistically significant(P<0.05).The overall analysis showed that there were statistically significant differences in pain scores of NRS and Wong-Baker facial makeup among groups,time points and interaction(P<0.05).Further pairwise comparison and intra-group comparison:NRS and Wong-Baker facial pain scores at time points in the two groups showed statistically significant differences(P<0.05);comparison between groups:NRS and Wong-Baker facial pain scores of experimental group were lower than those of control group at 4,12 h and 24 h after surgery,and the differences were statistically significant(P<0.05);the SF-36 score of experimental group was higher than that of control group,and the difference was statistically significant(P<0.05).The total complication rate of experimental group was lower than that of control group,and the difference was statistically significant(P<0.05).Nursing satisfaction of experimental group was better than that of control group,and the difference was statistically significant(P<0.05).Conclusion The application of ERAS nursing model after laparoscopic surgery has significant effects on patients with gallstones and cholecystitis, promoting the rapid postoperative recovery of patients, accelerating the process of rehabilitation, effectively alleviating postoperative pain and reducing the occurrence of complications, and significantly improving the postoperative quality of life and satisfaction of patients.