基于多学科协作的加速康复外科模式在间质性膀胱炎患者中的应用

Effect of enhanced recovery after surgery model based on muti-disciplinary team in patients with interstitial cystitis

目的:探讨基于多学科协作的加速康复外科模式在间质性膀胱炎患者中的应用效果。方法:2018年1月—2021年12月,采用便利抽样法选取首都医科大学附属北京朝阳医院泌尿外科收治的90例间质性膀胱炎患者为研究对象,2018年1月—2019年6月纳入的44例患者设为对照组,2019年7月—2021年12月纳入的46例患者设为观察组。对照组给予传统围手术期护理模式,观察组实施基于多学科协作的加速康复外科模式。比较两组术后恢复情况及疼痛视觉模拟量表、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、生活质量综合评定问卷-74(GQOL-74)得分及护理满意度。结果:观察组患者术后首次排气、进食及住院时间短于对照组,术后有胃肠道反应的患者例数少于对照组,差异有统计学意义(P<0.05)。术后1、3 d及出院时,观察组患者疼痛视觉模拟量表评分均低于对照组,差异有统计学意义(P<0.05)。出院时,观察组患者HAMA和HAMD评分低于对照组,差异有统计学意义(P<0.05)。出院时,观察组患者心理功能、躯体功能、物质生活、社会功能维度评分及护理满意度均高于对照组,差异有统计学意义(P<0.05)。结论:基于多学科协作的加速康复外科模式可以减轻间质性膀胱炎患者的负性情绪,缩短住院时间,提高护理满意度及患者的生活质量,值得临床推广应用。

Objective To explore the effect of enhanced recovery after surgery model based on muti-disciplinary team in patients with interstitial cystitis.Methods From January 2018 to December 2021,a total of 90 patients with interstitial cystitis in Urology Department of Beijing Chaoyang Hospital,Capital Medical University were selected as the research objects using the convenience sampling method,44 patients from January 2018 to June 2019 were enrolled as the control group,46 patients from July 2019 to December 2021 were enrolled as the observation group.The control group received traditional perioperative care model,and the observation group conducted enhanced recovery after surgery model based on multidisciplinary collaboration.The postoperative recovery status and scores of Visual Analogue Scale,Hamilton Anxiety Inventory(HAMA),Hamilton Depression Inventory(HAMD),General Quality of Life Questionnaire-74(GQOL-74)and nursing satisfaction were compared between the two groups.Results The time of postoperative first venting,feeding and postoperative hospitalization of the observation group were shorter than those of the control group,and the number of patients with postoperative gastrointestinal reaction was less than that of the control group,and the differences were statistically significant(P<0.05).One,three day after surgery and at discharge,the scores of Visual Analogue Scale of the observation group were lower than that of the control group,and the differences were statistically significant(P<0.05).At discharge,the scores of HAMA and HAMD of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).At discharge,the scores of mental function,physical function,material life,social function and nursing satisfaction of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusions Enhanced recovery after surgery model based on muti-disciplinary team can reduce the negative emotions of patients with interstitial cystitis,shorten the length of hospital stay,improve nursing satisfaction and patients'quality of life,which is worthy of clinical application.