加速康复理念(ERAS)在腹腔镜胰十二指肠切除术围术期护理中的运用价值分析

Application Value of Enhanced Recovery after Surgery(ERAS)in Perioperative Nursing of Laparoscopic Pancreaticoduodenectomy

目的研究腹腔镜胰十二指肠切除术治疗的患者运用加速康复理念护理的效果。方法方便选取2023年7月—2024年6月于广西医科大学第一附属医院行腹腔镜胰十二指肠切除术的72例患者为研究对象,按照护理方法不同分为两组,各36例。对照组行常规护理,观察组行基于加速康复理念的护理。对比两组康复时间指标、围术期体温、并发症发生情况。结果观察组术后下床活动时间为(1.11±0.33)d、术后排气时间为(1.67±0.35)d、引流管拔除时间为(4.52±1.34)d、术后住院时间为(8.46±2.35)d,均短于对照组的(2.03±0.46)d、(2.14±0.39)d、(8.45±1.52)d、(10.64±2.84)d,差异有统计学意义(t=9.750、5.381、11.636、3.548,P均<0.05)。两组术前体温比较,差异无统计学意义(P>0.05);观察组术中1 h、手术结束时、离开复苏室时的体温均高于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论在腹腔镜胰十二指肠切除术围术期开展加速康复理念的护理可稳定患者的体温指标,减少术后并发症的发生,加速康复进程,具有良好的临床价值。

Objective To study the effect of enhanced recovery after surgery nursing in patients undergoing laparoscopic pancreaticoduodenectomy.Methods A total of 72 patients who underwent laparoscopic pancreaticoduodenectomy in the First Affiliated Hospital of Guangxi Medical University from July 2023 to June 2024 were conveniently selected as the study objects.They were divided into two groups according to different nursing methods,36 cases in each group.The control group received routine nursing,and the observation group was given nursing based on the concept of enhanced recovery after surgery.The rehabilitation time indexes,perioperative body temperature and complications were compared between the two groups.Results The postoperative ambulation time of the observation group was(1.11±0.33)d,the postoperative exhaust time was(1.67±0.35)d,the drainage tube removal time was(4.52±1.34)d,and the postoperative hospitalization time was(8.46±2.35)d,which were shorter than(2.03±0.46)d,(2.14±0.39)d,(8.45±1.52)d,(10.64±2.84)d of the control group,the differences were statistically significant(t=9.750,5.381,11.636,3.548,all P<0.05).There was no significant difference in preoperative temperature parameters between the two groups(P>0.05).The body temperature in the observation group were higher than those in the control group at 1 h,at the end of the operation and after leaving the resuscitation room,and the differences were statistically significant(all P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The nursing of the concept of enhanced recovery after surgery during the perioperative period of laparoscopic pancreaticoduodenectomy can stabilize the patient's body temperature index,reduce the occurrence of postoperative complications,and accelerate the rehabilitation process,which has good clinical value.