Clinical Study of Applying Enhanced Recovery after Surgery Concept in Single-Segment Lumbar Spinal Stenosis Surgery

Objective: With the aging population and changes in lifestyle, lumbar spinal stenosis has become a common spinal disorder. Treatment modalities have been advancing, and the application of Enhanced Recovery After Surgery (ERAS) principles provides a new approach to postoperative recovery in patients. This study aims to investigate the clinical application effects of ERAS principles in single-level lumbar spinal stenosis surgery. Methods: This study included 64 patients who underwent lumbar fusion surgery in the Spinal Surgery Department of Baise People’s Hospital from July 2022 to July 2024. These patients were divided into an experimental group (ERAS group, 33 cases) and a control group (conventional group, 31 cases) based on perioperative care, receiving ERAS principles and traditional treatment, respectively. A comparison was made between the two groups in terms of gender, age, BMI, intraoperative blood loss, postoperative length of hospital stay, postoperative complications, hospital costs, VAS scores (preoperative/postoperative day 3), and ODI scores (preoperative/postoperative day 3). Results: There were no significant differences in gender, age, and BMI between the ERAS group and the conventional group (gender: χ2 = 0.5008, P = 0.4792;age: 54.55 ± 8.51 years vs. 57.39 ± 8.16 years, P = 0.0892;BMI: 25.11 ± 2.70 vs. 24.77 ± 2.75, P = 0.3098). However, during surgery, patients in the ERAS group had significantly less blood loss than those in the conventional group (197.58 ± 195.51ml vs. 438.71 ± 349.22 ml, P = 0.0006), and the postoperative length of hospital stay was significantly shorter (7.00 ± 2.24 days vs. 11.55 ± 5.23 days, P = 0.0000). On postoperative day 3, VAS scores were significantly better in the ERAS group compared to the conventional group (3.70 ± 0.88 vs. 4.32 ± 0.87, P = 0.0031), and the ODI scores showed significant improvement as well (46.00 ± 3.04 vs. 48.00 ± 3.39, P = 0.0078). Although there were no significant differences in postoperative complications and hospital costs (complications: 3 cases vs. 0 cases, P = 0.2154;hospital costs: 63524.29 ± 17891.80 RMB vs. 58733.84 ± 13280.82 RMB, P = 0.1154), ERAS demonstrated better postoperative recovery outcomes in single-level lumbar spinal stenosis surgery. Conclusion: The study results support the implementation of ERAS principles in single-level lumbar spinal stenosis surgery to promote rapid recovery, reduce healthcare resource consumption, and improve overall patient satisfaction.

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.

Enhanced recovery after surgery strategy to shorten perioperative fasting in children undergoing non-gastrointestinal surgery:A prospective study

BACKGROUND Enhanced recovery after surgery strategies are increasingly implemented to improve the management of surgical patients.AIM To evaluate the effects of new perioperative fasting protocols in children≥3 mo of age undergoing non-gastrointestinal surgery.METHODS This prospective pilot study included children≥3 mo of age undergoing nongastrointestinal surgery at the Children’s Hospital(Zhejiang University School of Medicine)from January 2020 to June 2020.The children were divided into either a conventional group or an ERAS group according to whether they had been enrolled before or after the implementation of the new perioperative fasting strategy.The children in the conventional group were fasted using conventional strategies,while those in the ERAS group were given individualized fasting protocols preoperatively(6-h fasting for infant formula/non-human milk/solids,4-h fasting for breast milk,and clear fluids allowed within 2 h of surgery)and postoperatively(food permitted from 1 h after surgery).Pre-operative and postoperative fasting times,pre-operative blood glucose,the incidence of postoperative thirst and hunger,the incidence of perioperative vomiting and aspiration,and the degree of satisfaction were evaluated.RESULTS The study included 303 patients(151 in the conventional group and 152 in the ERAS group).Compared with the conventional group,the ERAS group had a shorter pre-operative food fasting time[11.92(4.00,19.33)vs 13.00(6.00,20.28)h,P<0.001],shorter preoperative liquid fasting time[3.00(2.00,7.50)vs 12.00(3.00,20.28)h,P<0.001],higher preoperative blood glucose level[5.6(4.2,8.2)vs 5.1(4.0,7.4)mmol/L,P<0.001],lower incidence of thirst(74.5%vs 15.3%,P<0.001),shorter time to postoperative feeding[1.17(0.33,6.83)vs 6.00(5.40,9.20),P<0.001],and greater satisfaction[7(0,10)vs 8(5,10),P<0.001].No children experienced perioperative aspiration.The incidences of hunger,perioperative vomiting,and fever were not significantly different between the two groups.CONCLUSION Optimizing fasting and clear fluid drinking before non-gastrointestinal surgery in children≥3 mo of age is possible.It is safe and feasible to start early eating after evaluating the recovery from anesthesia and the swallowing function.

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.

Introducing an enhanced recovery after surgery program in colorectal surgery:A single center experience

AIM: To study the implementation of an enhanced recovery after surgery (ERAS) program at a large University Hospital from &#x0201c;pilot study&#x0201d; to &#x0201c;standard of care&#x0201d;.

Enhanced recovery for colorectal surgery: Practical hints, results and future challenges

Enhanced recovery after surgery (ERAS) protocols are now achieving worldwide diffusion in both university and district hospitals with special interest in colorectal surgery. The optimization of the patient’s preoperative clinical conditions, the careful intraoperative administration of fluids and drugs and the postoperative encouragement to resume the normal physiological functions as early as possible has produced results in a large amounts of studies. These approaches successfully challenged long-standing and well-established perioperative managements and finally achieved the status of gold standard treatments for the perioperative management of uncomplicated colorectal surgery. Even more important, it seems that the clinical improvement of the patient’s clinical management through ERAS protocols is now reaching his best outcomes (length of stay of 4-6 d after the operation) and therefore any further measures add little to the results already established (i.e., the adjunct of laparoscopic surgery to ERAS). Still dedicated meetings and courses around the world are exploring new aspects including the improvement the preoperative nutrition status to provide the energy necessary to face the surgical stress, the preoperative individuation of special requirements that could be properly addressed before the date of surgery and therefore would reduce the number of unnecessary days spent in hospital once fully recovered (i.e., rehabilitation, social discharges), and finally the development of an important web of out-of-hours direct access in order to individuate alarm symptoms in those patients at risk of complications that could prompt an early readmission.

基于加速康复外科理念的骨水泥强化型防旋股骨近端髓内钉治疗在老年骨质疏松性股骨转子间骨折中的应用效果

目的探讨基于加速康复外科(ERAS)理念的骨水泥强化型防旋股骨近端髓内钉(PFNA)治疗在老年骨质疏松性股骨转子间骨折中的应用效果。方法选取东台市人民医院2021年1月至2022年10月收治的40例老年骨质疏松性股骨转子间骨折患者为研究对象,采用随机数字表法分为对照组(20例)和观察组(20例)。对照组采用ERAS理念联合PFNA治疗,观察组采用ERAS理念联合骨水泥强化型PFNA治疗,并对两组进行为期6个月的随访。比较两组髋关节Harris评分优良率、髋关节活动角度、手术及恢复情况、生活质量及并发症。结果观察组术后6个月髋关节Harris评分优良率高于对照组,观察组住院时间、骨折愈合时间、术后下地行走时间、负重练习时间均短于对照组,总并发症发生率低于对照组,差异有统计学意义(P<0.05);两组的手术时间、术中出血量的比较,差异无统计学意义(P>0.05);观察组术后6个月的欧洲五维健康量表(ED-5Q)各项评分低于对照组,髋关节活动角度大于对照组,差异有统计学意义(P<0.05)。结论ERAS理念下的骨水泥强化型PFNA治疗老年骨质疏松性股骨转子间骨折患者能提高治疗优良率,提高患者生活质量,增加髋关节活动角度,且并发症发生率低。

基于快速康复外科理念的激励式护理在腹腔镜全子宫切除术患者术后康复中的应用效果

目的 探讨基于快速康复外科理念的激励式护理在腹腔镜全子宫切除术患者术后康复中的应用效果。方法 选取2020年7月至2023年7月于肇庆市第二人民医院行腹腔镜全子宫切除术的70例患者作为研究对象,采用随机数字表法分为对照组(n=35)和试验组(n=35)。对照组接受常规护理干预,试验组在对照组基础上接受基于快速康复外科理念的激励式护理干预,比较两组自我效能感、心理状态、术后恢复情况和术后并发症发生情况。结果 干预后,试验组自我效能感量表评分高于对照组,焦虑自评量表、抑郁自评量表评分均低于对照组(P <0.05)。试验组术后肠鸣音恢复、肛门排气、排便、下床活动和住院时间均短于对照组(P <0.05)。试验组术后并发症总发生率为5.71%,低于对照组的22.86%(P <0.05)。结论 基于快速康复外科理念的激励式护理在腹腔镜全子宫切除术患者术后康复中的应用效果较好,可改善患者自我效能感和心理状态,促进患者术后康复,减少术后并发症。

ERAS药学服务在老年结直肠癌手术患者中的应用研究

目的 探讨加速康复外科(ERAS)理念药学服务在老年结直肠癌手术患者中的应用效果。方法 选取2023年1月~12月重庆医科大学附属永川医院就诊的122例老年结直肠癌手术患者进行研究。使用随机数字表法分为试验组(n=61)与对照组(n=61)。对照组给予常规治疗,试验组在常规治疗的基础上接受ERAS理念药学服务。干预结束后比较两组的实验室指标[白蛋白(ALB)、前白蛋白(PA)、C反应蛋白(CRP)、降钙素原(PCT)]、镇痛效果[视觉模拟评分(VAS)]、用药依从性[Morisky药物依从性量表(MMAS-8)]、住院期间并发症发生率、住院经济指标以及药品不良反应发生率。结果 术后3 d,试验组ALB、PA水平高于对照组,CRP、PCT水平低于对照组(P <0.05)。试验组VAS评分低于对照组,MMAS-8评分高于对照组(P <0.05)。试验组住院期间并发症发生率1.64%低于对照组11.48%(P <0.05)。试验组住院总费用、住院药物总费用、药占比均低于对照组(P <0.05)。试验组药品不良反应发生率3.28%低于对照组13.11%(P <0.05)结论 ERAS理念药学服务在老年结直肠癌手术患者中应用良好,可改善患者营养状态、炎症反应,减轻患者术后疼痛,提高患者用药依从性,降低住院期间并发症发生率、药品不良反应发生率,减少患者治疗费用。

中药穴位贴敷联合ERAS理念对结直肠癌患者术后康复、并发症风险及护理满意度的影响

目的:分析中药穴位贴敷联合加速康复外科理念(ERAS)对结直肠癌患者术后康复、并发症风险及护理满意度的影响。方法:选取2021年1月—2023年12月佛山市第一人民医院收治的300例结直肠癌术后患者,按照随机抽签法分为观察组和对照组,各150例。对照组采取ERAS护理,观察组采取中药穴位贴敷联合ERAS护理。比较两组的干预效果。结果:观察组排气时间、肠鸣音恢复时间和排便时间均短于对照组,差异有统计学意义(P<0.05)。术后1周,观察组中医症候积分低于对照组,差异有统计学意义(P<0.05);观察组住院时间短于对照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论:在结直肠癌患者术后采取中药穴位贴敷联合ERAS理念干预取得了良好的应用效果。

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。

基于快速康复外科理念的精细化护理在颅脑损伤患者术后护理中的应用效果

目的探讨基于快速康复外科(FTS)理念的精细化护理在颅脑损伤患者术后护理中的应用效果。方法选取2021年9月—2023年9月我院收治的76例颅脑损伤手术患者为研究对象,按随机数字表法将其分为对照组和观察组,各38例。对照组采取常规护理,观察组采取基于FTS理念的精细化护理。对比两组术后恢复情况、不适症状、并发症发生率及护理满意度。结果护理后,观察组下床活动时间及住院时间均短于对照组,术后72 h疼痛视觉模拟评分低于对照组,Kolcaba的简化舒适状况量表中各维度评分均高于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率为5.26%,低于对照组的21.05%,差异有统计学意义(P<0.05)。观察组护理总满意度为97.37%,高于对照组的78.95%,差异有统计学意义(P<0.05)。结论基于FTS理念的精细化护理能促进颅脑损伤患者术后恢复,减轻身心不适,减少并发症,提高护理满意度。

基于ERAS理念的手术室护理模式在全髋关节置换术患者中的应用效果

目的探讨基于加速康复外科(ERAS)理念的手术室护理模式在全髋关节置换术患者中的应用效果。方法选取2021年7月至2022年7月于本院接受诊治的80例全髋关节置换术患者作为研究对象,以随机数字表法将其分为对照组和观察组,各40例。对照组予以常规手术室护理,观察组予以基于ERAS理念的手术室护理模式。比较两组的术后恢复指标、并发症发生情况、髋关节功能、疼痛程度以及应激反应指标。结果观察组的术后下地活动时间、首次排气时间、首次排便时间以及住院时间均短于对照组,并发症总发生率低于对照组(P<0.05)。护理后,观察组的Harris评分高于对照组,视觉模拟评分法(VAS)评分低于对照组(P<0.05)。护理后,两组的去甲肾上腺素(NE)、C反应蛋白(CRP)、皮质醇(Cor)水平均升高,但观察组低于对照组(P<0.05)。结论基于ERAS理念的手术室护理模式能明显降低全髋关节置换术患者术后疼痛感及应激反应,改善髋关节功能,促进康复,提升预后效果。

基于加速康复外科理念的护理干预在腹腔镜胆囊切除术患者围手术期的应用效果

目的 探讨基于加速康复外科(ERAS)理念的护理干预在腹腔镜胆囊切除术(LC)患者围手术期的应用效果。方法 选取2021年1月至2022年3月河北省邯郸市中心医院接受LC治疗的100例患者为研究对象,采用随机数字表法将其分为常规组和干预组,各50例。常规组实施常规围手术期护理,干预组在常规组的基础上行ERAS理念下围手术期护理。观察并比较两组应激反应指标水平变化、术后疼痛程度、并发症发生情况及患者术后康复速度。结果 术后24 h,两组皮质醇、肾上腺素水平均高于术前1 h,且干预组术前1 h、术后24 h时指标水平低于常规组,差异有统计学意义(P<0.05);干预组术后视觉模拟评分法评分、并发症总发生率低于常规组,差异有统计学意义(P<0.05);干预组术后首次下床、肛门首次排气、首次排便、停止输液及住院时间均短于常规组,差异有统计学意义(P<0.05)。结论 基于ERAS理念围手术期干预模式用于LC治疗患者,可避免患者出现强烈应激反应,缓解疼痛感,预防并发症发生,缩短患者术后康复时间。

基于ERAS理念的家庭参与式护理对斜视患儿术后恢复的影响

目的探讨基于加速康复外科(ERAS)理念的家庭参与式护理对斜视患儿术后恢复的影响。方法选择2022年7月至2023年1月郑州大学第一附属医院河医院区收治的200例斜视患儿为研究对象,按随机数表法将患儿分为观察组和对照组,每组各100例。对照组患儿给予常规护理,观察组患儿接受基于ERAS理念的家庭参与式护理,均连续护理3个月。比较两组患儿护理前及护理3个月后的视力、视觉模拟疼痛评分(VAS)、应激反应(收缩压、舒张压、心率),采用生活质量简表(SF-36)评估两组患儿护理前及护理3个月后的生活质量变化,并统计两组患儿的并发症发生情况。结果护理前,两组患儿的视力、VAS评分比较差异均无统计学意义;护理后,两组患儿的视力均显著升高,且观察组患儿的视力为0.98±0.16,明显高于对照组的0.76±0.14,而VAS评分均显著降低,且观察组患儿的VAS评分为(3.71±0.59)分,明显低于对照组的(4.89±0.62)分,差异均有统计学意义(P<0.05);护理前,两组患儿的应激反应指标比较差异均无统计学意义;护理后,两组患儿的舒张压、收缩压、心率均显著升高,但观察组患儿的舒张压、收缩压、心率分别为(95.10±4.19)mm Hg、(108.31±7.12)mm Hg、(109.45±5.93)次/min,明显低于对照组的(99.57±5.01)mm Hg、(121.45±6.09)mm Hg、(130.47±6.73)次/min,差异均有统计学意义(P<0.05);护理前,两组患儿的生理功能、生理职能、情感职能、精神健康评分比较差异均无统计学意义;护理后,两组患儿的上述指标均显著升高,且观察组分别为(72.09±4.18)分、(73.09±5.09)分、(70.19±5.29)分、(71.28±4.29)分,明显高于对照组的(63.29±4.21)分、(64.28±4.98)分、(63.28±4.87)分、(63.09±4.19)分,差异均有统计学意义(P<0.05);观察组患儿的并发症总发生率为6.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论基于ERAS理念的家庭参与式护理可促进斜视患儿术后视力恢复,缓解疼痛及应激反应,提高患儿生活质量,降低并发症,安全性高,值得临床推广运用。

肝癌患者术后出院饮食依从性研究

目的调查肝癌患者术后出院饮食依从性的现状,并分析其相关影响因素。方法采用方便抽样的方法,选取2021年11月—2022年3月福州市某三甲医院的肝癌术后的患者作为研究对象,收集一般资料于术后出院一个月随访并填写饮食依从性量表,进行数据分析。结果肝癌患者术后饮食依从性总分为(31.30±3.34)分,饮食依从性在年龄、文化程度、居住地、家庭人均月收入方面上存在差异,即年龄≤60岁、学历在大专以上、居住在城镇、家庭人均月收入>5000元的研究对象饮食依从性得分较高(均P<0.05)。Pearson相关性分析显示,研究对象饮食依从性与年龄和居住地之间呈负相关,饮食依从性与文化程度和收入之间呈正相关。结论肝癌患者术后出院饮食依从性总体较好,在临床护理中,应加强对年龄大于60岁、文化程度较低、家庭人均月收入较低人群的关注,开展个体化的健康教育将能提高患者的饮食依从性,从而促进机体的恢复。

加速康复外科理念下艾司氯胺酮应用于骨科手术的研究进展

随着加速康复外科(Enhanced recovery after surgery,ERAS)理念的推广应用,骨科手术麻醉围术期的快速康复管理不断更新完善。氯胺酮是唯一具有镇痛作用的静脉麻醉药,由于存在明显的心血管系统不良反应及精神运动反应,目前其应用明显受限。艾司氯胺酮作为氯胺酮的右旋单体,起效更快,对呼吸循环系统影响轻微,体内消除迅速,精神副作用小,更加安全有效,有利于加快患者术后恢复,提升医疗质量。本文对ERAS理念下,艾司氯胺酮在骨科手术麻醉领域的应用研究进展进行综述。

快速康复外科理念的舒适化手术室护理对腰椎退行性疾病患者术后谵妄的影响

目的分析在腰椎退行性疾病手术中实施基于快速康复外科(ERAS)理念的舒适化手术室护理的效果及对其术后谵妄的影响。方法选择2021年5月—2023年3月医院接受手术治疗的腰椎退行性疾病患者103例作为研究对象,按照组间基本特征具有可比性的原则分为对照组52例和观察组51例。对照组行常规手术室护理,观察组在对照组基础上行基于ERAS理念的舒适化手术室护理,比较两组患者术后麻醉苏醒情况、谵妄发生风险和疼痛情况,并统计两组术中并发症和术后谵妄发生情况。结果观察组患者术后自主呼吸恢复时间、意识恢复时间和完全清醒时间均短于对照组,差异有统计学意义(P<0.05)。双因素重复测量方差分析结果显示,术后24 h、术后48 h两组患者3D-CAM评分、VAS评分均较术后12 h降低,不同时间比较差异有统计学意义(P时间<0.05),术后24 h、术后48 h观察组3D-CAM评分、VAS评分低于对照组,差异有统计学意义(P组间<0.05),随着观察时间延长,3D-CAM组间随时间变化差异减小,VAS术后48 h差异减小,差异有统计学意义(P交互<0.05)。观察组术中并发症总发生率和术后谵妄发生率低于对照组,差异有统计学意义(P<0.05)。结论基于ERAS理念的舒适化手术室护理可有效提高腰椎退行性疾病手术患者术后麻醉苏醒质量和效率,减轻术后疼痛,减少术中不良反应的发生,进而有效地降低其术后谵妄风险。

基于集束化护理的快速康复外科理念在心脏外科手术护理中的应用

心脏外科手术复杂且合并症多,技术难度大,术后并发症及病死风险高,因此科学、系统、规范的护理对术后患者尤为重要。集束化护理的核心优势是将一系列的护理措施标准化、流程化,从而提升护理质量,保证治疗效果。快速康复外科理念应用于临床,可有效预防术后并发症,缩短患者康复时间。二者结合能更好地发挥护理效果,提高临床治愈率。本文对基于集束化护理的快速康复外科理念在心脏外科手术护理中的应用进行综述,以期为心脏外科临床护理工作提供参考。