加速康复外科护理理念在经皮肾镜取石术患者中的临床护理应用效果分析

Efficacy analysis of the clinical application of ERAS nursing concept in patients with percutaneous nephrolithotomy

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)护理理念在经皮肾镜取石术患者围手术期临床护理中的应用效果。方法选择2016年1月—2017年4月由蚌埠医学院第一附属医院泌尿外科收住的32例肾结石患者,其中男性20例,女性12例,平均年龄54.5岁,结石大小2.1~5.6 cm,多发结石6例,单发结石26例,伴肾积水4例。随机分为ERAS组和对照组,每组16例。2组患者性别、年龄、病情严重程度差异无统计学意义。32例患者均接受手术治疗,手术方式均采用经皮肾镜钬激光碎石术。对照组采用传统护理模式进行围手术期护理。ERAS组采用ERAS理念指导的层级整体护理模式进行围手术期护理。ERAS组医护患三方密切沟通,注重医护人员的责任意识提高和医患关系、护患关系和谐,让患者主动参与,注重护理反馈,动态性和针对性更强。比较2组患者术后不良事件发生率、住院时间及患者满意度。应用SPSS 19.0统计学软件对所收集的资料和数据进行统计分析,P<0.05为差异有统计学意义。结果 ERAS组患者较对照组患者术后不良事件发生率低,住院时间缩短,患者满意度高,2组差异有统计学意义(P<0.05)。结论 ERAS护理理念指导下经皮肾镜取石术的围手术期护理可以加快患者的手术康复。

Objective To investigate the clinical nursing efficacy of the ERAS nursing concept in perioperative period of percutaneous nephrolithotomy. Methods We selected 32 patients with nephrolith treated in the surgical urology department of the first affiliated hospital of Bengbu medical college from January,2016 to April,2017. Among these cases,there were 20 males,22 females,with an average age of 54. 5 years. The mean stone size was 2. 1 cm × 5. 6 cm. There were 6 cases of multiple calculus,26 cases of solitary calculus,and 4 cases accompanying hydronephrosis. These patients were randomly divided into the ERAS and the control group,with 16 cases in each group. There were no statistical differences in gender,age and severity between the two groups. All 32 patients received percutaneous nephrolithotomy. The control group adopted the traditional nursing mode for perioperative nursing. The ERAS group adopted the hierarchical holistic nursing model for perioperative nursing under the guidance of the ERAS concept. Doctors,nurses and patients communicated closely in ERAS group,paying attention to the improvement of the medical personnel's responsibility consciousness and harmonious medical relationship. In ERAS group,patients participated actively. The ERAS group paid attention to nursing feedback and managed dynamically and pertinently. The incidence of adverse events,patient satisfaction and hospital stays were compared between the two groups. We conducted a statistical analysis for the collected data by using SPSS19. 0 statistical software( when P < 0. 05,the difference is statistically significant). Results Compared with the control group,the incidence of adverse events was lower,the hospital stays was shorter and the patient's satisfaction was higher in the ERAS group( P < 0. 05). Conclusion The perioperative nursing of percutaneous nephrolithotomy under the guidance of the ERAS can accelerate the recovery of patients.