基于ERAS理念的系统化护理在经尿道前列腺钬激光剜除术患者中的应用效果

Application Effect of Systematic Nursing Based on ERAS Concept in Patients with Transurethral Holmium Laser Enucleation of the Prostate

目的:探讨基于加速康复外科(ERAS)理念的系统化护理在经尿道前列腺钬激光剜除术(HOLEP)患者中的应用效果。方法:选取2022年1—12月于建德市第一人民医院行HOLEP手术治疗的85例患者。按随机数表法将其分为对照组(n=42,接受常规护理措施干预)、观察组(n=43,接受基于ERAS理念的系统化护理)。两组均持续护理至出院。比较两组术后疼痛程度、尿路症状、术后康复情况、并发症发生情况及生活质量评分。结果:护理前,两组疼痛数字评分法(NRS)评分、国际前列腺症状评分(IPSS)评分比较,差异无统计学意义(P>0.05)。护理后,观察组NRS评分、IPSS评分均低于对照组,差异有统计学意义(P<0.05)。观察组首次肛门排气时间、下床活动时间均早于对照组,尿管留置时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。护理前,两组生活质量综合评定问卷-74(GQOL-74)各项评分比较,差异无统计学意义(P>0.05);护理后,两组GQOL-74量表中认知功能、社会功能、躯体功能及心理状态维度评分高于护理前,且观察组上述评分均高于对照组,差异有统计学意义(P<0.05)。结论:HOLEP患者经基于ERAS理念的系统化护理后,可减轻患者术后疼痛,降低患者尿路症状严重程度,加快患者康复,有效预防尿失禁、尿路感染发生,促进生活质量提升。

Objective:To investigate the application effect of systematic nursing based on enhanced recovery after surgery(ERAS)concept in patients with transurethral holmium laser enucleation of the prostate(HOLEP).Method:A total of 85 patients who underwent HOLEP surgery at the First People's Hospital of Jiande City from January to December 2022 were selected.They were divided into control group(n=42,receiving routine nursing interventions)and observation group(n=43,receiving systematic nursing based on ERAS concept)according to the random number table method.Both groups continued to receive nursing until the patient was discharged.The degree of postoperative pain,urinary tract symptoms,postoperative rehabilitation,complications and quality of life score were compared between the two groups.Result:Before nursing,there were no significant differences in pain numerical rating scale(NRS)score and international prostate symptom score(IPSS)between the two groups(P>0.05).After nursing,the NRS score and IPSS score in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The first time of anal exhaust and the time of getting out of bed in the observation group were earlier than those in the control group,and the time of urinary catheter indentation and hospitalization were shorter than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before nursing,there were no statistically significant differences in the scores of generic quality of life inventory 74(GQOL-74)between the two groups(P>0.05).After nursing,the scores of cognitive function,social function,physical function,and psychological state dimensions in the GQOL-74 scale of the two groups were higher than those before nursing,and the above scores in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:After systematic nursing based on ERAS concept,HOLEP patients can alleviate postoperative pain,reduce the severity of urinary tract symptoms,accelerate patient recovery,effectively prevent urinary incontinence and urinary tract infections,and promote quality of life improvement.