基于ERAS理念下的早期下床活动方案对多发肋骨骨折患者术后康复及依从性的影响

Influence of early ambulation program based on ERAS concept on postoperative rehabilitation and compliance of patients with multiple rib fractures

目的探讨基于快速康复外科(ERAS)理念的早期下床活动方案对多发肋骨骨折患者术后康复及依从性的影响。方法选取上海市第六人民医院2022年1月至9月收治的98例多发肋骨骨折患者,按照随机数字表法将其分为ERAS组和常规组,各49例。常规组实施常规护理干预,ERAS组在常规组基础上实施基于ERAS理念的早期下床活动干预方案。比较两组术后引流量、拔除引流管时间和住院时间、疼痛数字评定量表(NRS)评分及依从性。结果ERAS组术后引流量少于常规组,拔除引流管时间、住院时间短于常规组,差异有统计学意义(P<0.05)。两组NRS评分时间点比较、组间比较及交互作用差异均有统计学意义(P<0.05)。组内比较:两组NRS评分各时间点比较,差异均有统计学意义(P<0.05);组间比较:ERAS组各时间点NRS评分低于常规组,差异有统计学意义(P<0.05)。ERAS组依从性优于常规组,差异有统计学意义(P<0.05)。结论基于ERAS理念的早期下床活动干预方案有利于减轻多发肋骨骨折患者术后疼痛,促进术后尽快康复,并提高患者依从性,值得推广。

Objective To investigate the effect of early ambulation program based on the concept of enhanced recovery after surgery(ERAS)on postoperative rehabilitation and compliance in patients with multiple rib fractures.Methods A total of 98 patients with multiple rib fractures who were admitted to Shanghai Sixth People’s Hospital from January to September 2022 were selected,and they were divided into ERAS group and routine group by random number table method,with 49 cases in each group.The routine group was given routine nursing intervention,the ERAS group was given early ambulation program based on the ERAS concept on the basis of control group.The postoperative drainage volume,drainage tube removal time,hospital stay,NRS score after surgery,and compliance were compared between the two groups.Results The postoperative drainage volume in ERAS group was less than that in conventional group,and the time of drainage tube removal and hospital stay in ERAS group were shorter than those in conventional group,with statistical significances(P<0.05).There were statistically significant differences in NRS score point comparison,inter-group comparison and interaction between the two groups(P<0.05).Intra-group comparison:NRS scores of the two groups were compared at each time point,and the differences were statistically significant(P<0.05).Comparison between groups:NRS score of ERAS group at each time point was lower than that of conventional group,and the difference was statistically significant(P<0.05).The compliance of ERAS group was better than that of conventional group,with statistical significance(P<0.05).Conclusion The early ambulation program based on ERAS concept is beneficial to relieve postoperative pain in patients with multiple rib fractures,promote postoperative recovery,and improve patient compliance,which is worthy of promotion.