ERAS护理模式在椎间盘镜手术围术期的应用

Application of ERAS nursing model in the perioperative period of microendoscopic discectomy

目的探讨接受椎间盘镜手术治疗的腰椎间盘突出症患者在围术期应用ERAS护理模式的临床效果。方法回顾性分析2020年3月~2021年9月潍坊市中医院收治的接受椎间盘镜手术治疗96例腰间盘突出症患者临床资料,其中44例采用ERAS护理模式(ERAS组),52例采用常规护理模式(常规护理组)。比较两组患者围术期资料及随访过程中疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及患者满意度。结果所有患者均顺利完成手术,术后随访平均(7.63±3.25)个月。两组手术时间相比无统计学差异(P>0.05),ERAS组术中失血量,住院天数均少于常规护理组,ERAS组术后首次排气、排便时间,首次下床时间均早于常规护理组(P<0.05),ERAS组住院天数、并发症少于常规护理组(P<0.05),ERAS组患者满意度高于常规护理组(P<0.05)。两组的VAS、ODI评分均随时间延长而降低,均较术前明显改善(P<0.05)。在术后3d,ERAS组VAS评分低于常规护理组(P<0.05),术后1个月、3个月、6个月及末次随访,两组VAS、ODI评分无明显统计学差异(P>0.05)。结论在椎间盘镜手术围术期应用ERAS护理模式具有缩短患者住院时间,减少术后疼痛与并发症、加快患者康复等优点。

Objective To investigate the clinical effect of using enhanced recovery after surgery(ERAS)nursing model in perioperative period in patients with lumbar disc herniation treated by microendoscopic discectomy surgery.Methods The clinical data of 96 patients with lumbar disc herniation treated by microendoscopic discectomy in Weifang Hospital of Traditional Chinese Medicine from March 2020 to September 2021 were analyzed retrospectively,of which 44 cases were treated with ERAS nursing mode(ERAS group)and 52 cases with routine nursing mode(routine nursing group).The perioperative data,visual analogue scale of pain(VAS)and Oswestry dysfunction index(ODI)were compared between the two groups.Results All patients had completed the operation successfully,and the average follow-up time was(7.63±3.25)months.There was no significant difference in the operation time between the two groups.The intraoperative blood loss and hospitalization days in the ERAS group were less than those in the routine nursing group.The time of the first exhaust,defecation and getting out of bed after operation in the ERAS group were earlier than those in the routine nursing group.The hospitalization days and the incidence of complications in the ERAS group were less than those in the routine nursing group.The patient satisfaction in the ERAS group was higher than that in the routine nursing group.The scores of VAS and ODI in both groups decreased with the prolongation of time,and were significantly improved compared with those before operation.On the 3rd day after operation,the VAS score in the ERAS group was lower than that in the routine nursing group,and there was no significant difference in VAS and ODI scores between the two groups at 1 month,3 months,6 months and the last follow-up.Conclusion The perioperative application of ERAS nursing model in microendoscopic discectomy has the advantages of shortening the hospitalization time,reducing postoperative pain and complications,and speeding up the recovery of patients.