摘要
目的分析基于加速康复外科(ERAS)理念的临床护理路径在腹腔镜袖状胃切除术中的应用价值。方法筛选徐州医科大学附属医院减重代谢中心2020年7月至2021年4月收治的265例行腹腔镜袖状胃切除术的肥胖症患者进行回顾性分析。依据不同的护理模式,将接受常规护理的患者纳入对照组(130例),将接受基于ERAS理念开展临床护理路径的患者纳入观察组(135例)。对比2组患者的术后恢复情况、并发症发生情况,以及疼痛程度、应激指标和营养状态变化。结果观察组的术后下床活动时间、排气时间、进食时间、住院时间和住院费用均优于对照组(P均<0.05)。观察组的术后并发症合计发生率为4.44%,较对照组的11.54%更低(P<0.05)。2组在术后1 d、3 d及5 d的视觉模拟评分法(VAS)评分均高于同组术前(P均<0.05);观察组在术后1 d、3 d及5 d的VAS评分均低于同期对照组(P均<0.05)。2组在术后3 d的白细胞和中性粒细胞计数均较术前升高,白蛋白和前白蛋白水平均较术前下降(P均<0.05),且观察组在术后3 d的上述指标均优于对照组(P均<0.05)。结论基于ERAS理念开展临床护理路径有助于促进行腹腔镜袖状胃切除术的患者术后康复,减轻术后疼痛,降低术后并发症发生风险,并调节患者的应激反应和营养状态。
Objective To analyze the application value of clinical nursing pathway based on the concept of enhanced recovery after surgery(ERAS)in the laparoscopic sleeve gastrectomy.Methods From July 2020 to April 2021,265 patients who underwent laparoscopic sleeve gastrectomy in the Weight Loss and Metabolism Center of the Affiliated Hospital of Xuzhou Medical University were enrolled in a retrospective study.According to the nursing models of the patients,those who received routine nursing were included in the control group(n=130),and those who received clinical nursing pathway based on the ERAS concept were included in the observation group(n=135).The postoperative recovery,complications,pain intensity,stress indicators,and nutritional status of the two groups were compared.Results The time of getting out of bed,exhausting time,eating time,hospitalization time,and hospitalization expenses in the observation group were better than those in the control group(all P<0.05).The total incidence of postoperative complications was lower in the observation group than in the control group(4.44%vs.11.54%,P<0.05).The Visual Analogue Scale(VAS)scores of the two groups at 1,3,and 5 days after operation were higher than those before operation(all P<0.05),while the VAS scores of the observation group were lower than those of the control group at 1,3,and 5 days after operation(all P<0.05).At 3 days after operation,the white blood cell and neutrophil counts in the two groups increased,and the albumin and prealbumin levels decreased compared with those before operation(all P<0.05).The above indicators in the observation group were better than those in the control group at 3 days after operation(all P<0.05).Conclusion The clinical nursing pathway based on the ERAS concept is helpful to promote the postoperative rehabilitation of patients undergoing laparoscopic sleeve gastrectomy,relieve the postoperative pain,reduce the risk of postoperative complications,and regulate the stress response and nutritional status.
作者
孙霞
李芹
裴新荣
张燕
杨丽
SUN Xia;LI Qin;PEI Xinrong;ZHANG Yan;YANG Li(Weight Loss and Metabolism Center,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221004,China)
出处
《中西医结合护理（中英文）》
2022年第8期17-20,共4页
Journal of Clinical Nursing in Practice
关键词
腹腔镜袖状胃切除术
加速康复外科
临床护理路径
围手术期管理
laparoscopic sleeve gastrectomy
enhanced recovery after surgery
clinical nursing pathway
perioperative management
