Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery

BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.

Fast-track surgery could improve postoperative recovery in radical total gastrectomy patients

AIM: To assess the impact of fast-track surgery (FTS) on hospital stay, cost of hospitalization and complications after radical total gastrectomy. METHODS: A randomized, controlled clinical trial was conducted from November 2011 to August 2012 in the Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, the Fourth Military Medical University. A total of 122 gastric cancer patients who met the selection criteria were randomized into FTS and conventional care groups on the first day of hospitalization. All patients received elective standard D2 total gastrectomy. Clinical outcomes, including duration of flatus and defecation, white blood cell count, postoperative pain, duration of postoperative stay, cost of hospitalization and complications were recorded and evaluated.Two specially trained doctors who were blinded to the treatment were in charge of evaluating postoperative outcomes, discharge and follow-up. RESULTS: A total of 119 patients finished the study, including 60 patients in the conventional care group and 59 patients in the FTS group. Two patients were excluded from the FTS group due to withdrawal of consent. One patient was excluded from the conventional care group because of a non-resectable tumor. Compared with the conventional group, FTS shortened the duration of flatus (79.03 ± 20.26 hvs 60.97 ± 24.40 h, P = 0.000) and duration of defecation (93.03 ± 27.95 h vs 68.00 ± 25.42 h, P = 0.000), accelerated the decrease in white blood cell count [P < 0.05 on postoperative day (POD) 3 and 4], alleviated pain in patients after surgery (P < 0.05 on POD 1, 2 and 3), reduced complications (P < 0.05), shortened the duration of postoperative stay (7.10 ± 2.13 dvs 5.68 ± 1.22 d,P = 0.000), reduced the cost of hospitalization (43783.25 ± 8102.36 RMBvs 39597.62 ± 7529.98 RMB,P = 0.005), and promoted recovery of patients. CONCLUSION: FTS could be safely applied in radical total gastrectomy to accelerate clinical recovery of gastric cancer patients.

Fast-track program in laparoscopic liver surgery:Theory or fact?

AIM:To analyze our results after the introduction of a fast-track(FT) program after laparoscopic liver surgery in our Hepatobiliarypancreatic Unit.METHODS:All patients(43) undergoing laparoscopic liver surgery between March 2004 and March 2010 were included and divided into two consecutive groups:Control group(CG) from March 2004 until December 2006 with traditional perioperative cares(17 patients) and fast-track group(FTG) from January 2007 until March 2010 with FT program cares(26 patients).Primary endpoint was the influence of the program on the postoperative stay,the amount of re-admissions,morbidity and mortality.Secondarily we considered duration of surgery,use of drains,conversion to open surgery,intensive cares needs and transfusion.RESULTS:Both groups were homogeneous in age and sex.No differences in technique,time of surgery or conversion to open surgery were found,but more malignant diseases were operated in the FTG,and then transfusions were higher in FTG.Readmissions and morbidity were similar in both groups,without mortality.Postoperative stay was similar,with a median of 3 for CG vs 2.5 for FTG.However,the 80.8% of patients from FTG left the hospital within the first 3 d after surgery(58.8% for CG).CONCLUSION:The introduction of a FT program after laparoscopic liver surgery improves the recovery of patients without increasing complications or re-admissions,which leads to a reduction of the stay and costs.

Effects of multimodal fast-track surgery on liver transplantation outcomes

BACKGROUND: Fast-track surgery and enhanced recovery after surgery have been applied to many surgical procedures; however, data on fast-track surgery and enhanced recovery after surgery following liver transplantation is limited. This study aimed to conduct a prospective study to determine the effects of fast-track surgery on prognosis after liver transplantation. METHODS: This was a prospective, single-blinded, randomized study. One hundred twenty-eight patients undergoing liver transplantation were selected for the fast-track (FT group, n=54) or conventional process (NFT group, n=74). The primary endpoints were intensive care unit (ICU) stay and hospital stay. The secondary endpoints were as follows: operative time, anhepatic phase time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative complications, readmission rate, and postoperative mortality. RESULTS: There was no significant difference in preoperative demographics between the two groups. The median ICU stay was 2 days (range 1-7 days) in the FT group and 5 days (range 3-12 days) in the NFT group (P<0.01). Furthermore, the hospital stay was also significantly reduced in the FT group (P<0.01). The operative time, anhepatic phase time, intraoperative blood loss, and intraoperative blood transfusion volume were decreased in the FT group compared with the NFT group (P<0.05). Based on Spearman correlation analysis, the ICU stay and hospital stay may be positively correlated with operative time, anhepatic phase time and intraoperative blood loss. There were no differences in the incidence of postoperative complications, readmissions, and postoperative mortality between the two groups. CONCLUSION: Fast-track procedures effectively reduce the ICU stay and hospital stay without adversely affecting prognosis. This study demonstrated that fast-track protocols are safe and feasible in liver transplantation.

A 5-Year Review of Gynaecological Oncology Patients Managed by a Fast Track Surgery Program

Introduction: The aim of this study is to provide a comprehensive 5-year audit of patients undergoing laparotomy for suspected or confirmed gynaecological malignancy to document the frequency and incidence of adverse events and to investigate factors associated with shorter length of stay and readmission to hospital. Methods: A 5-year surgical audit of the period commencing 2008 and concluding 2012. All patients undergoing laparotomy were included in the audit without exclusions. Approval was granted by the local Ethics Review Committee. Results: Four hundred and twenty-seven patients underwent laparotomy for suspected or confirmed gynaecological malignancy and were managed by Fast Track Surgery (FTS) principles. Average age was 54.8 years and average weight and BMI were 73.4 kg and 28.1 respectively. Ultimately 254 (59%) patients had confirmed malignancy. Average surgery duration was 2.36 hours and average estimated blood loss (EBL) at surgery was 262 mL. Median and mean LOS was 3.0 and 3.5 days respectively with 125 (29%) patients discharged on day 2. Overall transfusion rate was 5%. Other adverse events in decreasing frequency were hospital readmission (3.7%), significant wound infection (3%) and unplanned High Dependency Unit (HDU) admission (1.4%). All other adverse events were uncommon with rates <0.5%. Factors associated with a short LOS included year of surgery, age, performance status, malignant vs benign pathology, the use of COX-2 inhibitors, operation time, incision type, transfusion, and radical hysterectomy, at least 1 complication, if patients tolerated early oral feeding (EOF). In multivariable analysis, year, age, performance status, the use of COX-2 inhibitors, operation time and incision type were significant. Factors associated with readmission included the use of COX-2 inhibitors, operation time, performance of a lymph node dissection, return to operating theatre, operation category at least 1 complication, and in multivariable analysis lymph node dissection and the occurrence of at least 1 complication were significant. Conclusions: This 5-year audit is important in establishing a contemporary incidence and the prevalence rate of serious adverse events for patients with suspected or confirmed gynaecological cancer undergoing laparotomy and managed by FTS principles. The community can be reassured that the incidence of serious adverse events is low when managed by FTS principles.

Fast-track rehabilitation vs conventional care in laparoscopic colorectal resection for colorectal malignancy: A meta-analysis

AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE,the Cochrane Central Register of Controlled Trials and EMBASE.The complications and re-admission after approximately 1 mo were assessed.RESULTS:Six recent randomized controlled trials(RCTs)were included in this meta-analysis,which related to 655 enrolled patients.These studies demonstrated that compared with LCC,LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo.LFT had a pooled RR of 0.60(95%CI:0.46-0.79,P<0.001)compared with a pooled RR of 0.69(95%CI:0.34-1.40,P>0.5)for LCC.CONCLUSION:LFT for colorectal malignancy is safe and efficacious.Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.

Early discharge after major gynaecological surgery: advantages of fast track surgery

Introduction: Fast Track Surgery (FTS) programs have been adopted by many specialties with documented improved patient outcomes and reduced length of stay (LOS). Methods: We initiated a FTS program in January 2008 and present our experience up to and including November 2010 on patients whose LOS was 2 days. Results: During the study period 242 patients had a laparotomy performed. Overall 54(22.3%) patients were discharged on day 2. In the first year of initiating our FTS program 10% were discharged on day 2, 25% in year 2 and 31% in year 3. Twenty-two patients (41%) had malignant pathology and of these, 16 (73%) had local or regional spread and 6 (27%) had distant spread. Forty patients (74%) had vertical midline incisions (VMI) performed. Surgery was classified as complex in 40 cases (74%) and 6 (11%) patients underwent staging lymph node dissection. Average patient BMI was 26.1 with 44% of patients considered overweight or obese. There were no intraoperative complications recorded. When compared to 188 patients whose LOS was greater than 2 days, the early discharge cohort were more likely to have benign pathology, more likely to be younger, to have a transverse incision, to have received COX II inhibitors, to have a lower net haemoglobin (Hb) change and to tolerate early oral feeding. Conclusions: Increased clinical experience with FTS enables over 31% patients undergoing laparotomy to be safely discharged on day 2 without an increase in the read-mission rate or morbidity.

Effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery: A systematic review

Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.

Fast Track Gynaecologic Surgery in the Overweight and Obese Patient

Introduction: To review the outcomes of overweight and obese patients undergoing laparotomy and managed with a Fast Track Surgical (FTS) protocol. Methods: Between January 2008 and May 2010 patients having a laparotomy and managed on a FTS protocol were identified. They were compared to patients with a normal body mass index (BMI). Data was collected in a real time fashion and analysis undertaken in a retrospective fashion. Results: 194 patients were identified, 94 (48.4%) classified as normal BMI, 51 (26.3%) as overweight and 49 (25.3%) as obese. A vertical midline incision was performed in 170 (88%) patients. When comparing the group of overweight/obese patients (n = 100) to those with a normal BMI (n = 94) there was no significant difference in the number of benign or malignant pathologies, FIGO stage, age, insurance status, complexity of surgery, operation duration, blood loss, haemoglobin change, or need for transfusion. The proportion of patients successfully fast tracked and able to tolerate early oral feeding was similar. Patients classified as overweight or obese were significantly more likely to have a poorer performance status, have un?dergone vertical midline incision and to have had COX II inhibitors withheld. The median length of stay (LOS) was 3 days for the patients with a normal BMI and also 3 days for those overweight or obese. Conclusions: Overweight and obese patients undergoing a fast track surgical protocol after laparotomy for gynaecological surgery have similar out comes when compared to patients of normal body mass index.

快速康复外科理念在3D-slicer优化入路三叉神经痛围手术期护理中的应用

目的 探讨快速康复外科(FTS)理念在3D-slicer软件辅助优化手术入路三叉神经痛的围手术期护理中的应用效果。方法 将2021年1月至2022年12月在安徽省阜阳市人民医院诊断为三叉神经痛的71例患者作为研究对象,所有患者均行3D-slicer软件辅助优化手术入路的经皮穿刺球囊压迫术治疗,采用随机数字表法将其分为对照组(36例)和观察组(35例),对照组采取围手术期常规护理,观察组在对照组基础上加用FTS理念干预,比较两组干预前后心理弹性量表(CD-RISC)评分和术前及术后24、48、72 h视觉模拟评分法(VAS)评分,比较两组舒适状况问卷(GCQ),记录两组术后并发症发生情况。结果 干预后,两组CD-RISC各项评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组术后24、48、72 h的VAS评分均低于术前,术后48、72 h低于术后24 h,术后72 h低于术后48 h,且观察组术后24、48、72 h的VAS评分均低于同期对照组,差异有统计学意义(P<0.05)。观察组GCQ中生理、社会文化、心理精神维度评分均高于对照组,并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论 3D-slicer软件辅助优化手术入路的经皮穿刺球囊压迫术治疗的三叉神经痛患者围手术期护理中采用FTS理念干预,能明显提高患者心理弹性水平,降低术后疼痛,改善舒适性,降低手术并发症,有利于促进术后康复进程。

Fast Track Surgery and Its Outcome in Colorectal Surgery in a Tertiary Care Hospital

Background: Fast track surgery is an evidence-based multidisciplinary approach. The underlying principle is to enable patients to recover from surgery and leave the hospital sooner by minimizing the stress responses on the body during surgery. Our aim was to compare the outcome of fast-track protocol and conventional methods in colorectal surgery. Method: It was an observational cross-sectional study carried out at the Department of Surgery in different tertiary level hospitals, Dhaka Bangladesh during the period January 2014 to December 2017. Among this population, 50 patients were placed in the fast-track program (Group A) from January 2014 to December 2015 and 50 patients were in the conventional method (Group B), from January 2016 to December 2017. The fast-track patients were selected after receiving ethical approval from the Bangladesh College of Physician & Surgeons. Data analysis was done using the statistical package for social science (SPSS) for windows version 20. Results: The average age of the patients was 45.24 ± 16.65 years (range: 11 - 70 years) in the fast track group (Group A) and 43.24 ± 17.76 years in the conventional method (Group B). The majority were female between two groups, with 56% in group A and 52% in group B. General and surgical complications occurred in 9 (18%) patients and 11 (22%) patients respectively in group A. On the other hand in group B general and surgical complications occurred in 10 (20%) patients and 13 (26%) patients respectively. The average hospital stay was 9.24 ± 5.99 days in group A and the average hospital stay was 10.10 ± 6.04 days in group B. Conclusion: Making the decision to adopt fast-track surgery will challenge current traditional practice for all members of the multidisciplinary team across the whole local health community.

Fast track clinical pathway implications in esophagogastrectomy

AIM： To investigate the feasibility of fast track clinica pathway for esophageal tumor resections. METHODS： One hundred and fourteen patients with esophageal carcinoma who underwent esophagogastrectomy from January 2006 to October 2007 in our department were studied. Fast track clinical pathway included analgesia control, fluid infusion volume control, early ambulation and enteral nutrition. Nasogastric tube was removed 3 d after operation and chest tube was removed 4 d after operation as a routine, and full liquid diet 5 d after operation. RESULTS： Among 114 patients （84 men and 30 women）, 26 patients underwent fast track surgery, including 17 patients over 65 years old and 9 under 65 （P = 0.014）; 18 patients who had preoperative complications could not bear fast track surgery （P 〈 0.001）. No significant differences in tolerance of fast track surgery were attributed to differences in gender, differentiated degree or stage of tumor, pathological type of tumor, or operative incision. The median length of hospital stay was 7 d （5-28 d）, 4% patients were readmitted to hospital within 30 d of discharge. Three patients died and postoperative mortality was 2.6%. All 3 patients had no determinacy to fast track surgery approach.CONCLUSION： The majority of patients with esophageal carcinoma can tolerate fast track surgery. Patients younger than 65 or who have no preoperative diseases have the best results. Median length of hospital stay has been reduced to 7 d.

Assessing outcomes after fast track surgical management of corpus cancer

Objective: The aim of the study was to audit the outcomes of patients with corpus cancer managed with a fast track surgery (FTS) program. Design: Clinical audit of outcomes after laparotomy for corpus cancer and managed by FTS principles. Setting: Tertiary hospital, University based subspecialty gynaecological oncology practice. Population or Sample: Consecutive patients with uterine corpus cancer. There were no exclusions. Methods: Three year audit of FTS Database. Main Outcome Measures: Ability to tolerate early oral feeding (EOF), length of stay (LOS), perioperative complication rate and readmission rate. Results: Sixty six patients were operated upon whose median age was 59.5 years. Forty six (70%) had stage I disease, 7 (11%) stage II, 9 (14%) stage III and 4 (6%) had stage IV disease. Twenty seven (41%) had lymph node sampling performed. Median operating time was 2.5 hours. Mean BMI was 30 kg/m2 (Range: 18 - 47). Fifty patients (76%) were classified as over-weight or obese. Twenty four patients (36%) had a “non-zero” performance status. Mean intraoperative EBL was 227 ml. Median LOS was 3.0 days. There were 3 (5%) intraoperative complications. There were no intraoperative ureteric, bowel or vascular injuries. Postoperatively, 13 (20%) patients experienced a total of 24 adverse events. Only 2 (3%) patients experienced complications greater than grade 2. Conclusion: This audit shows that in an unselected group of patients undergoing laparotomy as management for their uterine malignancy and managed by a FTS protocol, overall excellent results can be achieved.

快速康复外科-集束干预策略模式在经PICC置管的胃癌患者中的应用效果

目的探讨快速康复外科-集束干预策略(FTS-CIS)模式在经外周静脉穿刺的中心静脉导管(PICC)的胃癌患者中的应用效果。方法选取2019年4月至2021年6月河南省肿瘤医院收治的89例接受PICC的胃癌患者作为研究对象,按随机数表法分为观察组(45例,接受FTS-CIS模式干预措施)和对照组(44例,接受常规护理模式干预措施)。比较两组患者焦虑、抑郁情况、并发症发生率、自我护理能力和护理满意度。结果干预后观察组患者焦虑、抑郁评分均低于对照组(P<0.05)。观察组发症总发生率(6.66%)低于对照组(22.72%)(P<0.05)。干预后观察组患者肿瘤患者PICC自我管理能力量表(CPPSM)评分高于对照组(P<0.05)。观察组患者护理总满意率(97.77%)高于对照组(81.81%)(P<0.05)。结论FTS-CIS模式干预措施可减少胃癌患者PICC相关并发症的发生,缓解其不良情绪,提高其自我护理能力及护理满意度。

FTS-CNP模式的护理干预对胫骨平台骨折患者术后康复及VAS评分的影响

目的:探讨快速康复外科(FTS)联合临床护理路径(CNP)对胫骨平台骨折患者术后康复及视觉模拟评分法(VAS)评分的影响。方法:选取2020年2月—2022年2月泉州市第一医院城东分院骨科收治的200例胫骨平台骨折患者,按照入院时间分为两组,各100例。对照组实施常规护理,观察组在对照组基础上实施FTS-CNP模式的护理干预。比较两组术后康复指标,采用VAS评价两组不同时间点的疼痛程度,并对两组Lysholm膝关节评分、并发症发生率、日常生活活动能力及护理满意度进行比较。结果:观察组术后康复指标均优于对照组(P<0.05)。与术前比较,两组术后3 d、出院时VAS评分均降低(P<0.05);与术后3 d比较,两组出院时VAS评分均降低,观察组术后3 d VAS评分低于对照组(P<0.05)。术后90 d两组Lysholm膝关节评分、Barthel指数评分均较术前升高,且观察组均高于对照组(P<0.05)。观察组术后并发症发生率(7.00%)较对照组(24.00%)低(P<0.05)。观察组护理总满意度(93.00%)较对照组(80.00%)高(P<0.05)。结论:FTS-CNP模式的护理干预应用在胫骨平台骨折患者中的效果较好,可减轻患者术后疼痛,促进康复。

基于加速康复外科理念的手术室精准护理在直肠癌taTME患者中的应用

目的探究针对行经肛全直肠系膜切除术(taTME)的直肠癌患者采用以加速康复外科(FTS)理念为基础的手术室精准护理的应用效果。方法手术室自2022年6月至2023年8月,成立FTS理念的手术室精准护理小组,对在此期间收治的38例直肠癌患者(观察组)实施基于FTS理念的手术室精准护理,2021年3月至2022年5月实施常规手术室护理的42例直肠癌患者(对照组)。对比两组患者术中不良事件发生率、血压、心率水平、气管导管拔除时间、麻醉复苏室停留时间和术后康复情况指标。结果干预后,两组术中不良事件中躁动、寒战发生率比较差异无统计学意义(P>0.05),观察组术中低体温发生率,干预后血压、心率水平均低于对照组(均P<0.05);观察组气管导管拔除时间、麻醉复苏室停留时间、手术时长及术后首次排气时长均短于对照组(均P<0.05),两组并发症总发生率比较差异无统计学意义(P>0.05)。结论基于FTS理念的手术室精准护理应用于行taTME的直肠癌患者,能够有效降低患者手术应激反应,减少术中不良事件,且患者术后恢复更快。

继发性甲状旁腺功能亢进症患者加速康复外科护理服务需求的项目特征与关联性分析

目的探讨继发性甲状旁腺功能亢进症(SHPT)患者加速康复外科(FTS)护理服务需求的项目特征与关联性,以期为临床治疗提供参考。方法将2021年1月—2023年1月于河北医科大学第三医院接受FTS护理服务的100例SHPT患者作为研究对象,收集患者FTS护理服务项目需求;并以资料饱和为原则对患者进行半结构式访谈,采用Python中Apriori模块分析不同SHPT患者FTS护理服务需求项目的特征及关联性,计算项/项集的支持度、置信度和提升度;使用Colaizzi分析法进行质性研究分析。结果量性研究显示:FTS护理服务需求总数为52项,包括健康教育、心理护理、饮食护理、康复训练、用药护理、并发症预防护理6类;各项集支持度均>0.02,用药护理和康复训练支持度最高。质性研究结果显示:患者FTS护理服务需求共凝练出4个主题,分别为疾病知识技能需求、用药知识需求、康复护理需求、心理社会支持需求。结论SHPT患者存在不同的FTS护理服务需求,各项目间具有促进作用,管理过程中可根据项目关联特点,设置合理的服务项目,提高FTS护理服务水平。

FTS护理在冠脉搭桥手术患者围手术期中的应用效果

目的探讨加速康复外科(FTS)护理在冠脉搭桥手术(CABG)患者围手术期中的应用效果。方法选择2021年7月至2022年7月河南省胸科医院收治的接受常规围手术期护理的43例CABG患者作为研究对象,将其纳入对照组。另选取2022年8月至2023年8月医院收治的接受FTS围手术期护理的43例CABG患者作为研究对象,将其纳入观察组。两组均连续护理至患者出院,并随访3个月,比较两组患者围手术期指标[重症加强护理病房(ICU)监护时间、首次排气时间、下床活动时间、住院时间];比较不同时点(麻醉诱导前、血管吻合时、术毕时)两组应急指标(呼吸、心率、平均动脉压);比较两组护理前、护理3个月时心功能指标[左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]。结果住院期间,观察组ICU监护、首次排气、下床活动及平均住院时间均短于对照组(P<0.05);血管吻合时,两组患者呼吸、心率及平均动脉压均高于麻醉诱导前;术毕时,呼吸、心率及平均动脉压均低于血管吻合时,呈先上升后下降,观察组各时点均低于对照组(P<0.05);护理3个月时,两组LVEF高于护理前,LVESD及LVEDD低于护理前,观察组LVEF高于对照组,LVESD及LVEDD低于对照组(P<0.05)。结论FTS护理能够有效降低CABG患者应急反应,促进术后恢复,提高患者心功能。

基于快速康复外科理念的护理干预对腹主动脉瘤患者术后康复的影响

目的探讨基于快速康复外科(FTS)理念的护理干预对腹主动脉瘤患者术后康复的影响。方法选取医院2022年1月至2023年8月收治的腹主动脉瘤患者83例,按随机数字表法分为观察组(43例)和对照组(40例)。对照组患者予常规护理,观察组患者予基于FTS理念的护理。结果观察组患者的首次排气时间、术后下床时间、术后住院时间均显著短于对照组(P<0.05);观察组患者的术后4 h疼痛评分显著低于对照组(P<0.05);观察组患者的术后并发症发生率为6.97%,显著低于对照组的30.00%(P<0.05);观察组患者的护理总满意度为95.35%,显著高于对照组的75.00%(P<0.05)。结论基于FTS理念的护理干预用于腹主动脉瘤患者术后康复的效果良好,可缩短患者的首次排气时间和住院时间,促进术后早期康复,减少术后并发症,提高护理满意度。

快速康复外科理念对行颈椎前路手术患者术后并发症发生率及康复效果的影响

目的分析行颈椎前路手术的患者在护理期间应用快速康复外科理念的价值,评估对其术后并发症发生率以及康复效果产生的影响。方法选取2020年1月至2022年8月在东南大学附属中大医院接受颈椎前路手术治疗的104例患者开展对照研究,按照随机数字表法划分为对照组(52例)和观察组(52例)。对照组应用常规护理,观察组基于常规护理应用快速康复外科理念。对比2组的围手术期指标、吞咽功能及生活自理能力等。结果与对照组相比,观察组的手术时间、引流管留置时间和住院时间均更短,术中出血量更少,下床活动时间更早,并发症总发生率更低(P均<0.05)。术后1个月、3个月及6个月,观察组的Gugging吞咽功能评估量表评分和Barthel指数均高于同期对照组(P均<0.05),且2组均高于同组术前(P均<0.05)。结论行颈椎前路手术的患者接受快速外科理念护理不仅对促进其术后康复具有确切效果,还有助于改善患者的吞咽功能,提升其生活自理能力,并降低并发症发生率。