基于ERAS理念的联合式康复护理对经尿道前列腺钬激光剜除术患者术后恢复的影响

Effect of combined rehabilitation nursing based on ERAS concept on postoperative recovery of patients undergoing holmium laser enucleation of the prostate

目的 探讨基于快速康复外科(ERAS)理念的联合式康复护理对经尿道前列腺钬激光剜除术(HOLEP)患者术后恢复的影响。方法 将2021年4月至2022年5月在本院接受手术治疗的60例良性前列腺增生症患者作为研究对象,根据入院时间将其分为对照组(常规护理)和研究组(常规护理+基于ERAS理念的联合式康复护理),各30例。比较两组的护理效果。结果 研究组的术后首次肛门排气时间、排便时间、下床时间、尿管拔除时间及住院时间均短于对照组(P<0.05)。术后24 h、72 h、1周,研究组的视觉模拟疼痛评分(VAS)评分均低于对照组(P<0.05)。术后3 d,两组的促肾上腺皮质激素(ACTH)、肾上腺素(E)以及皮质醇(Cor)水平高于术前,但研究组低于对照组(P<0.05)。随访时,研究组的生活质量(QOL)、国际前列腺症状评分表(IPSS)评分低于对照组(P<0.05)。结论 基于ERAS理念的联合式康复护理用于HOLEP术后可明显加快患者术后恢复速度,减轻应激反应,促进患者生活质量改善。

Objective To explore the effect of combined rehabilitation nursing based on the concept of enhanced recovery after surgery(ERAS)on postoperative recovery of patients undergoing holmium laser enucleation of the prostate(HOLEP).Methods From April 2021 to May 2022,60 patients with benign prostatic hyperplasia who underwent surgical treatment in our hospital were divided into control group(routine nursing)and study group(routine nursing+combined rehabilitation nursing based on ERAS concept)by admission time,with 30 cases in each group.The nursing effects of the two groups were compared.Results The time of first postoperative anal exhaust,defecation,getting out of bed,catheter removal and hospitalization in the study group were shorter than those in the control group(P<0.05).At 24 h,72 h and 1 week after operation,the Visual Analogue Scale(VAS)score of the study group was lower than that of the control group(P<0.05).At 3 d after operation,the levels of adrenocorticotropic hormone(ACTH),adrenaline(E)and cortisol(Cor)in the two groups were higher than those before operation,but those in the study group were lower than the control group(P<0.05).At follow-up,the Quality of Life(QOL)and International Prostate Symptom Scale(IPSS)scores of the study group were lower than those of the control group(P<0.05).Conclusion Combined rehabilitation nursing based on ERAS concept can significantly accelerate the recovery rate of patients after HOLEP,reduce the stress response,and promote the improvement of patients'quality of life.