快速康复护理干预对腰麻剖宫产患者术后恢复的影响

The effect of rapid recovery nursing intervention on postoperative recovery of patients undergoing cesarean section under spinal anesthesia

目的探讨快速康复护理干预对腰麻剖宫产患者术后恢复的效果。方法选取2024年2月至2024年3月我院收治的120例择期剖宫产患者,按照随机数字表法分为快速康复护理组(E组)和常规护理组(R组),每组各60例。采用VAS评分评估两组患者术后6、12、24、48h的整体疼痛情况;7项广泛性焦虑症问卷(7-item generalized anxiety disorder ques-tionnaire,GAD-7)评估患者围术期的焦虑程度;记录患者术后首次肛门排气、排尿、下床活动和泌乳时间,以及不良反应、住院满意度评分、住院时间和匹兹堡睡眠质量指数量表(pittsburgh sleepquality index,PSQI)评分。结果术后不同时间点两组患者的VAS评分差异无统计学意义(P>0.05);E组术后第1、2天GAD-7评分显著低于R组(P<0.05),术后首次肛门排气、排尿、下床活动和泌乳的时间均少于R组(P<0.05),恶心呕吐和腹胀发生率低于R组(P<0.05),患者住院满意度及PSQI评分均优于R组(P<0.05);两组住院天数比较差异无统计学意义(P=0.329)。结论快速康复护理可降低患者术后焦虑和并发症,缩短首次肛门排气、排尿、下床活动及泌乳时间,提高患者住院满意度和睡眠质量,更有利于患者术后早期的康复。

Objective To explore the effects of rapid rehabilitation nursing intervention in patients undergoing cesarean section with spinal anesthesia.Methods From February to March 2024,120 patients undergoing cesarean section were selected.They were divided into a rapid rehabilitation nursing group after surgery(E group)and routine nursing group(R group)according to random number table method,60 in each group.VAS score was used to evaluate the composite pain after 6,12,24 and 48 h of operation.The 7-item Generalized Anxiety Disorder Questionnaire(GAD-7)was used to assess perioperative anxiety of the patients.The time to the first flatus,the first urination time,the time to the first ambulation,the breast milk secretion,the side effect,the satisfaction scores,the length of hospital stay and Pittsburgh Sleep Quality Index(PSQI)score were also recorded.Results There was no significant difference in VAS scores at different time points between the two groups after surgery(P>0.05).The GAD-7 score in the E group was significantly lower than those in the R group on the first and second day after surgery(P<0.05).The time to the first flatus,urination,ambulation and milk secretion were significantly shorter in the E group than those in the R group(P<0.05).The incidence of nausea,vomiting and abdominal distension in the E group was lower than those in the R group(P<0.05).Maternal satisfaction with overall postpartum experience and PSQI of the E group were greater than those of the R group.There was no significant difference in the length of hospital stay between the two groups(P=O.374).Conclusions The rapid rehabilitation nursing can reduce the postoperative anxiety and complications in patients,shorten the time to the first flatus,urination,ambulation and milk secretion.It also improves the maternal satisfaction and sleeping quality so that is more conducive to early postoperative recovery.