基于加速康复外科理念下的护理健康教育路径在腹腔镜肝癌切除术患者术后恢复中的应用

Application of nursing health education pathway based on the concept of enhanced recovery after surgery in postoperative recovery of patients underwent laparoscopic hepatocellular carcinoma resection

目的分析基于加速康复外科(ERAS)理念下的护理健康教育路径在腹腔镜肝癌切除术患者术后恢复中的应用价值。方法选取2019年6月至2021年6月于上海长征医院行腹腔镜肝癌切除术的患者102例,利用随机数字表法分为对照组(51例)和试验组(51例)。对照组给予传统健康教育,试验组在对照组的基础上给予基于ERAS理念下的护理健康教育路径,两组均干预至出院。比较两组围术期指标。干预前及干预后的焦虑、疼痛感、生活质量评分,干预后的护理满意度及治疗依从性评分。结果试验组腹腔引流管拔出时间(21.94±1.89)h、肛门排气排便时间(21.31±1.89)h、首次进食时间(10.26±1.14)h、术前准备时间(1.58±0.59)h、住院时间(7.57±0.74)h短于对照组(25.14±2.33)h、(23.93±1.94)h、(15.85±1.73)h、(1.96±0.64)h、(9.16±0.84)h,首次活动时间(32.64±6.73)min、首次活动距离(81.39±14.29)m长于对照组(22.74±4.83)min、(64.26±12.73)h,差异均有统计学意义(P<0.05)。干预后,两组情感状况、身体状况、社会状况、功能健康、肝胆特异性评分均高于干预前,且试验组高于对照组,差异均有统计学意义(P<0.05);两组状态焦虑、特质焦虑、静息时、活动时视觉模拟评分法(VAS)评分低于干预前,且试验组低于对照组,差异均有统计学意义(P<0.05)。干预后,试验组护理满意率为96.08%(49/51),高于对照组的78.43%(40/51),且试验组治疗依从性评分(10.84±1.12)分高于对照组(7.73±1.73)分,差异均有统计学意义(均P<0.05)。结论采用基于ERAS理念下的护理健康教育路径对腹腔镜肝癌切除术患者进行干预,可提高患者治疗依从性,缓解其焦虑感及疼痛感,进而可促进患者术后恢复,提高其护理满意度及生活质量。

Objective To analyze the application value of nursing health education pathway based on the concept of enhanced recovery after surgery(ERAS)in the postoperative recovery of patients underwent laparoscopic hepatocellular carcinoma resection.Methods A total of 102 patients who underwent laparoscopic hepatectomy in Shanghai Changzheng Hospital from June 2019 to June 2021 were selected and divided into control group(51 cases)and experimental group(51 cases)by random number table method.The control group was given traditional health education during perioperative period,while the experimental group was given nursing health education path based on ERAS concept on the basis of the control group,and both groups were intervened until discharge.The perioperative indicators were compared between the two groups.The scores of anxiety,pain and quality of life before and after intervention,and the scores of nursing satisfaction and treatment compliance after intervention were compared.Results The abdominal drainage tube removal time,anal exhaust and defecation time,first feeding time,preoperative preparation time and hospitalization time of the experimental group were(21.94±1.89)hours,(21.31±1.89)hours,(10.26±1.14)hours,(1.58±0.59)hours and(7.57±0.74)hours,respectively,which were shorter than those of the control group〔(25.14±2.33)hours,(23.93±1.94)hours,(15.85±1.73)hours,(1.96±0.64)hours,(9.16±0.84)hours〕.The first ambulation time(32.64±6.73)minutes and the first ambulation distance(81.39±14.29)meters of the observation group were longer than those of the control group〔(22.74±4.83)minutes and(64.26±12.73)meters〕,and the differences were statistically significant(P<0.05).After intervention,the emotional status,physical status,social status,functional health and hepatobiliary specificity scores of the two groups were higher than those before intervention,and the experimental group was higher than the control group,and the differences were statistically significant(P<0.05).The state anxiety,trait anxiety,resting and active Visual Analogue Scale(VAS)scores of the two groups were lower than those before intervention,and the experimental group was lower than the control group,and the differences were statistically significant(P<0.05).After intervention,the nursing satisfaction rate of the experimental group was 96.08%(49/51),which was higher than 78.43%(40/51)of the control group,and the treatment compliance score of the experimental group was(10.84±1.12),which was higher than(7.73±1.73)of the control group,and the differences were statistically significant(P<0.05).Conclusions The application of nursing health education pathway based on ERAS concept in patients with laparoscopic liver cancer resection can improve the treatment compliance of patients,relieve their anxiety and pain,and promote the postoperative recovery of patients,improve their nursing satisfaction and quality of life.