基于ERAS理念的家庭参与式护理对斜视患儿术后恢复的影响

Impact of family participatory nursing based on enhanced recovery after surgery concept on postoperative recovery of children with strabismus

目的探讨基于加速康复外科(ERAS)理念的家庭参与式护理对斜视患儿术后恢复的影响。方法选择2022年7月至2023年1月郑州大学第一附属医院河医院区收治的200例斜视患儿为研究对象,按随机数表法将患儿分为观察组和对照组,每组各100例。对照组患儿给予常规护理,观察组患儿接受基于ERAS理念的家庭参与式护理,均连续护理3个月。比较两组患儿护理前及护理3个月后的视力、视觉模拟疼痛评分(VAS)、应激反应(收缩压、舒张压、心率),采用生活质量简表(SF-36)评估两组患儿护理前及护理3个月后的生活质量变化,并统计两组患儿的并发症发生情况。结果护理前,两组患儿的视力、VAS评分比较差异均无统计学意义;护理后,两组患儿的视力均显著升高,且观察组患儿的视力为0.98±0.16,明显高于对照组的0.76±0.14,而VAS评分均显著降低,且观察组患儿的VAS评分为(3.71±0.59)分,明显低于对照组的(4.89±0.62)分,差异均有统计学意义(P<0.05);护理前,两组患儿的应激反应指标比较差异均无统计学意义;护理后,两组患儿的舒张压、收缩压、心率均显著升高,但观察组患儿的舒张压、收缩压、心率分别为(95.10±4.19)mm Hg、(108.31±7.12)mm Hg、(109.45±5.93)次/min,明显低于对照组的(99.57±5.01)mm Hg、(121.45±6.09)mm Hg、(130.47±6.73)次/min,差异均有统计学意义(P<0.05);护理前,两组患儿的生理功能、生理职能、情感职能、精神健康评分比较差异均无统计学意义;护理后,两组患儿的上述指标均显著升高,且观察组分别为(72.09±4.18)分、(73.09±5.09)分、(70.19±5.29)分、(71.28±4.29)分,明显高于对照组的(63.29±4.21)分、(64.28±4.98)分、(63.28±4.87)分、(63.09±4.19)分,差异均有统计学意义(P<0.05);观察组患儿的并发症总发生率为6.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论基于ERAS理念的家庭参与式护理可促进斜视患儿术后视力恢复,缓解疼痛及应激反应,提高患儿生活质量,降低并发症,安全性高,值得临床推广运用。

Objective To explore the impact of family participatory nursing based on enhanced recovery after surgery(ERAS)on postoperative recovery of children with strabismus.Methods A total of 200 children with strabis-mus admitted to the Heyi Hospital District,the First Affiliated Hospital of Zhengzhou University from July 2022 to Janu-ary 2023 were selected as the study objects.According to the random number table method,the children were divided in-to an observation group and a control group,with 100 children in each group.The children in the control group received routine care,while the children in the observation group received family participatory nursing based on the ERAS concept,for 3 months.The visual acuity,Visual Analogue Scale(VAS)score,and stress response(systolic blood pressure,diastolic blood pressure,heart rate)were compared between the two groups before and after 3 months of nursing.The quality of life(SF-36)was used to evaluate the quality of life of the two groups of children before and after 3 months of nursing,and the complications between the two groups were counted.Results Before nursing,there was no significant difference in visual acuity and VAS score between the two groups(P>0.05).After nursing,the visual acuity of the two groups in-creased significantly,and the visual acuity in the observation group was 0.98±0.16,which was significantly higher than 0.76±0.14 in the control group;the VAS score in the observation group was(3.71±0.59)points,significantly lower than(4.89±0.62)points in the control group(P<0.05).Before nursing,there was no significant difference in stress response in-dexes between the two groups(P>0.05).After nursing,the diastolic blood pressure,systolic blood pressure and heart rate of the two groups were significantly increased,but the diastolic blood pressure,systolic blood pressure,and heart rate in the observation group were(95.10±4.19)mmHg,(108.31±7.12)mmHg,and(109.45±5.93)times/min,respectively,which were significantly lower than(99.57±5.01)mmHg,(121.45±6.09)mmHg,and(130.47±6.73)times/min in the control group(P<0.05).Before nursing,there was no significant difference in the scores of physiological function,physiological function,emotional function,and mental health between the two groups(P>0.05).After nursing,the above indexes of the two groups were significantly increased,and above indexs in the observation group were(72.09±4.18)points,(73.09±5.09)points,(70.19±5.29)points,(71.28±4.29)points,which were significantly higher than(63.29±4.21)points,(64.28±4.98)points,(63.28±4.87)points,(63.09±4.19)points in the control group(P<0.05).The to-tal incidence of complications in the observation group was 6.00%,which was significantly lower than 18.00%in the control group(P<0.05).Conclusion Family participatory nursing based on ERAS concept can promote postoperative visual recovery,alleviate pain and stress reactions,improve the quality of life of children with strabismus,reduce compli-cations,and have high safety,which is worthy of clinical promotion and application.