颈段椎管肿瘤患者围术期加速康复护理方案的应用效果

Application effect of enhanced recovery after surgery nursing protocol in patients with cervical spinal canal tumors

目的 探讨对颈段椎管肿瘤患者围术期应用加速康复(ERAS)护理方案的效果。方法 本研究为前瞻性研究。根据研究纳入和排除标准,纳入2020年8月—2022年12月在本院行手术治疗的颈段椎管肿瘤患者80例,采用随机数字表法分为干预组和对照组,每组40例。干预组采用本研究自制的《脊髓肿瘤ERAS管理手册》护理方案,对照组采用常规护理模式护理,比较两组患者一般资料(术后首次下床时间、住院时间、住院费用)、疼痛评分、焦虑评分、生活质量评分、日常生活活动能力评分、日本颈椎功能学会评分、徒手肌力评分及术后并发症的发生率。计量资料符合正态分布的使用独立样本t检验、不符合正态分布的采用Mann-Whitney U检验;计数资料以例(%)表示,行χ^(2)或Fisher精确检验。结果 干预组术后首次下床时间、住院时间较对照组均明显缩短;出院前1 d,干预组患者生活质量评分、日常生活活动能力评分均高于对照组,焦虑评分、疼痛评分均低于对照组;术后电解质紊乱、血栓形成相关指标升高、发热、便秘的发生率均显著低于对照组,日本颈椎功能学会评分较对照组改善,以上指标两组差异均有统计学意义(P均<0.05)。两组住院费用、徒手肌力评分、疼痛发生率差异均无统计学意义(P均>0.05)。结论 颈段椎管肿瘤患者ERAS康复护理方案的应用,可有效缩短手术至首次下床时间、减少术后并发症发生率、缓解患者焦虑、提高患者日常生活能力。ERAS用于颈段椎管肿瘤患者的临床护理具有实用性和可行性。

Objective To explore the application effect of enhanced recovery after surgery(ERAS)nursing protocol for patients with cervical spinal canal tumors.Methods This study is a prospective research.Based on the inclusion and exclusion criteria,80 patients with cervical spinal canal tumors who underwent surgery in our hospital from August 2020 to December 2022 were included and randomly divided into an intervention group and a control group,with 40 patients in each group.The intervention group received care following our self-made"Spinal Tumor ERAS Management Manual",while the control group received conventional nursing care.General patient data(the time to first mobilization after surgery,length of hospital stay,hospitalization costs),pain scores,anxiety scores,quality of life scores,daily life activity ability scores,Japanese Orthopaedic Association(JOA)scores,manual muscle scores,and the incidence of postoperative complications were compared between the two groups.Normally distributed data were analyzed using independent sample t-tests,while non-normally distributed data were analyzed using the Mann-Whitney U tests.Count data were expressed as cases(percentages)and analyzed using the χ^(2) test or Fisher's exact test.Results In the intervention group,the time to first mobilization after surgery and the length of hospital stay were significantly shorter than those in the control group.On the first day before discharge,patients in the intervention group had higher quality of life scores and daily life activity ability scores than those in the control group,while their anxiety scores and pain scores were lower than those in the control group.The incidence rates of electrolyte imbalance,thrombosis-related indicators increased,fever,and constipation were significantly lower in the intervention group compared to the control group.Additionally,the JOA scores improved more in the intervention group than in the control group.All these differences of indicators were statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of hospitalization costs,manual muscle scores,and the incidence of pain(P>0.05).Conclusion The application of the ERAS recovery nursing protocol in patients with cervical spinal canal tumors can effectively shorten the time to first mobilization after surgery,reduce the incidence of postoperative complications,alleviate patient anxiety,and improve their daily life abilities.The clinical nursing application of ERAS in patients with cervical spinal canal tumors is practical and feasible.