加速康复外科理念指导下个案管理模式对前列腺增生手术患者疼痛程度与手术相关指标的影响

The Impact of Case Management Model Guided by ERAS Concept on Pain Level and Surgical Related Indicators in Patients undergoing Prostate Hyperplasia Surgery

目的 探讨加速康复外科(ERAS)理念指导下的个案管理模式对前列腺增生(BPH)手术患者疼痛程度与手术相关指标的影响。方法 选取2021年8月至2023年6月高安市中医院收治的74例BPH手术患者作为研究对象,按随机数字表法分为观察组与对照组,各37例。对照组予以常规护理,观察组采取ERAS理念指导下的个案管理模式。比较两组不良情绪、疼痛程度、手术相关指标、排尿功能及并发症发生率。结果 观察组护理后焦虑自评量表(SAS)评分(41.49±6.27)分、抑郁自评量表(SDS)评分(42.36±5.65)分、术后72 h视觉模拟评分法(VAS)评分(1.44±0.29)分,低于对照组的(47.34±5.12)分、(47.47±4.78)分、(2.07±0.33)分,差异有统计学意义(P<0.05);观察组肛门排气时间(20.23±2.50)h、下床活动时间(22.59±2.07)h、膀胱冲洗时间(25.56±3.90)h、尿管留置时间(3.06±0.42)d、住院时间(4.89±0.57)d,短于对照组的(24.49±2.11)h、(28.14±3.54)h、(31.44±4.18)h、(3.92±0.57)d、(6.22±1.53)d,差异有统计学意义(P<0.05);观察组残余尿量(31.15±4.06)ml低于对照组的(37.08±5.43)ml,最大尿流率(15.03±2.34)ml/s高于对照组的(12.36±3.09)ml/s,差异有统计学意义(P<0.05);观察组并发症发生率2.71%,低于对照组的21.62%,差异有统计学意义(P<0.05)。结论 ERAS理念指导下的个案管理模式可以减轻BPH患者术后疼痛、不良情绪,减少并发症,促进排尿功能恢复,缩短康复进程。

Objective To explore the effects of case management model guided by the concept of accelerated rehabilitation surgery(ERAS) on pain degree and surgery-related indicators in patients undergoing prostatic hyperplasia(BPH) surgery.Methods A total of 74 BPH surgery patients admitted to Gao 'an Hospital of Traditional Chinese Medicine from August 2021 to June 2023were selected as the study objects,and were divided into observation group and control group according to random number table method,with 37 cases in each group.The control group was given routine nursing,and the observation group was given case management under the guidance of ERAS.The adverse mood,pain degree,operation related indexes,urination function and complication rate were compared between the two groups.Results The observation group had a Self Rating Anxiety Scale(SAS)score of 41.49±6.27,a Self Rating Depression Scale(SDS) score of 42.36±5.65,and a Visual Analog Scale(VAS) score of 1.44±0.29 at 72 hours after surgery,which were lower than the control group's(47.34±5.12),(47.47±4.78),and(2.07±0.33)scores,and the difference was statistically significant(P<0.05);The anal exhaust time(20.23±2.50) h,bed activity time(22.59±2.07) h,bladder flushing time(25.56±3.90) h,urinary catheter retention time(3.06±0.42) d,and hospital stay time(4.89±0.57) d were shorter than the control group's(24.49±2.11) h,(28.14±3.54) h,(31.44±4.18) h,(3.92±0.57) d,and(6.22±1.53) d,and the difference was statistically significant(P<0.05);The residual urine volume(31.15±4.06) ml was lower than the control group's(37.08±5.43) ml,the maximum urine flow rate(15.03±2.34) ml/s was higher than that of the control group(12.36±3.09) ml/s,and the difference was statistically significant(P<0.05);The incidence of complications was 2.71%,lower than the control group's 21.62%,with a statistical difference(P<0.05).Conclusion Case management model guided by the ERAS concept can alleviate postoperative pain and negative emotions in BPH patients,reduce complications,promote urinary function recovery,and shorten the rehabilitation process.