多学科协作下快速康复外科模式在行腹腔镜子宫肌瘤剔除术患者围手术期中的应用观察

Observation on the Application of Enhanced Rehabilitation After Surgery Model Under Multidisciplinary Teamwork in the Perioperative Period of Patients Undergoing Laparoscopic Uterine Myomectomy

目的:探讨多学科协作下快速康复外科(ERAS-MDT)模式在行腹腔镜子宫肌瘤剔除术患者围手术期中的应用效果,为临床护理提供依据。方法:选取2019年8月—2021年7月电子科技大学医学院附属绵阳医院收治的104例行腹腔镜子宫肌瘤剔除术患者作为研究对象,按照入院时间将其先后分为对照组和观察组,每组各52例。对照组患者实施常规围手术期护理干预,观察组患者在常规护理基础上实施ERAS-MDT模式干预。比较两组患者术后康复指标(术中出血量、肛门排气时间、术后进食时间、住院时间)、收缩压(SBP)、心率(HR)、并发症发生率、生活质量[简明健康状况量表(SF-36)评分]及护理满意度。结果:观察组患者术后肛门排气时间、术后进食时间、住院时间明显短于对照组,差异有统计学意义(t=3.223、2.240、4.915,P<0.05)。麻醉后5 min,观察组患者SBP、HR明显高于对照组,差异有统计学意义(t=2.569、3.834,P<0.05)。观察组患者术后并发症发生率明显低于对照组,差异有统计学意义(χ^(2)=5.283,P<0.05)。干预后,观察组患者SF-36中各维度评分明显高于对照组,差异有统计学意义(t=3.130、2.424、5.471、3.407,P<0.05)。观察组患者术后护理满意度明显高于对照组,差异有统计学意义(χ^(2)=5.696,P<0.05)。结论:ERAS-MDT模式应用于行腹腔镜子宫肌瘤剔除术患者围手术期中,能够减轻患者应激反应,减少并发症,改善患者生活质量,加快患者康复,提高护理满意度。

Objective:To investigate the effect of enhanced rehabilitation after surgery under multidisciplinary teamwork(ERAS-MDT)model in the perioperative period of patients who underwent laparoscopic uterine myomectomy,and to provide a basis for clinical care.Methods:104 cases of laparoscopic uterine fibroid removal patients admitted to the hospital from August 2019 to July 2021 were selected as the study subjects,which were divided into the control group and the observation group according to the sequence of admission time,with 52 cases in each group.The control group implemented conventional perioperative nursing intervention,and the observation group implemented ERAS-MDT model intervention based on the control group.Postoperative recovery indexes(intraoperative bleeding,anal exhaustion time,postoperative feeding time,hospitalization time),systolic blood pressure(SBP),heart rate(HR),complication rate,quality of life[Brief Health Status Scale(SF-36)scores]and nursing care satisfaction were compared between the two groups.Results:The postoperative anal defecation time,postoperative feeding time,and hospitalization time of the observation group were significantly shorter than those of the control group,and the differences were statistically significant(t=3.223,2.240,4.915,P<0.05).At 5 min after anesthesia,SBP and HR of the observation group were significantly higher than those of the control group,and the differences were statistically significant(t=2.569,3.834,P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(χ^(2)=5.283,P<0.05).After the intervention,the scores of the dimensions in the SF-36 scale of the observation group were significantly higher than those of the control group,and the difference was statistically significant(t=3.130,2.424,5.471,3.407,P<0.05).The postoperative nursing satisfaction of the observation group was significantly higher than that of the control group,and the difference was statistically significant(χ^(2)=5.696,P<0.05).Conclusion:The ERAS-MDT model applied to the perioperative period of patients undergoing laparoscopic uterine myomectomy can reduce patient stress,decrease complications,improve patient quality of life,accelerate patient recovery,and increase satisfaction with postoperative care.