摘要
[目的]评价加速康复外科(early recovery after surgery,ERAS)护理在胸腰段脊柱骨折患者中的应用价值。[方法]2020年5月—2022年5月骨科收治的胸腰段脊柱骨折92例患者作为观察对象,按随机数字表法分为两组。所有患者均行手术复位、减压和椎弓钉内固定术;47例围手术期采用ERAS护理,45例采用常规护理。比较两组围手术期资料。[结果]两组患者均顺利手术,术中无严重并发症。术后早期并发症,ERAS组为6.4%;常规组为22.2%,两组间差异有统计学意义(P=0.001)。ERAS组在肠功能恢复时间[(7.2±1.1) h vs (10.4±2.3) h,P<0.001]、首次肛门排气时间[(9.5±2.2) h vs (16.4±2.6) h,P<0.001]、首次排便时间[(25.6±4.9) h vs (43.2±5.6) h,P<0.001]、术后下床活动时间[(3.1±0.6) d vs (5.3±1.1) d,P<0.001]和住院时间[(8.4±1.0) d vs (12.0±1.3) d,P<0.001]均显著优于常规组。随术后时间推移,两组患者疼痛VAS评分和GCQ评分均显著改善(P<0.05);术前两组间上述评分的差异无统计学意义(P>0.05),术后1~7 d,ERAS组的VAS和GCQ评分均显著优于常规组(P<0.05)。[结论]对胸腰段脊柱骨折患者实施ERAS护理,能促进患者肠功能恢复,缓解术后疼痛,提高舒适度。
[Objective]To evaluate the clinical significances of early recovery after surgery(ERAS)nursing in surgical treatment of thoracolumbar fractures.[Methods]From May 2020 to May 2022,a total of 96 patients with thoracolumbar spine fracture admitted to our department were divided into two groups according to random number table method.All patients in both group underwent surgical reduction,decompression and pedicle screw fixation.Of them,47 patients received ERAS nursing,while other 45 patients received conventional nursing.The perioperative data of the two groups were compared.[Results]All patients in both groups were operated on successfully without serious complications.Early postoperative complications were of 6.4%in the ERAS group,while 22.2%in the conventional group,which was statistically significant(P=0.001).The ERAS group proved significantly superior to the conventional group in terms of bowel function recovery time[(7.2±1.1)hours vs(10.4±2.3)hours,P<0.001],time of the first fart[(9.5±2.2)hours vs(16.4±2.6)hours,P<0.001],time of the first defecation[(25.6±4.9)hours vs(43.2±5.6)hours,P<0.001],postoperative ambulation time[(3.1±0.6)days vs(5.3±1.1)days,P<0.001]and hospital stay[(8.4±1.0)days vs(12.0±1.3)days,P<0.001].The VAS score for pain and general comfort questionnaire(GCQ)score were significantly improved in both groups over time(P<0.05),which were not statistically significant between the two groups before operation(P>0.05),whereas in the ERAS group were significantly better than those in the conventional group 1 to 7 days postoperatively(P<0.05).[Conclusion]ERAS nursing used in the perioperative period for thoracolumbar fractures does promote the recovery of intestinal function,relieve postoperative pain and improve comfort of the patients.
作者
王妍丽
王晓霞
尹海磊
WANG Yan-li;WANG Xiao-xia;YIN Hai-lei(The 971^(st)Hos-pital of PLA Navy,Qingdao 266071,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第16期1530-1533,共4页
Orthopedic Journal of China
关键词
胸腰段脊柱骨折
手术治疗
围手术期
加速康复外科护理
常规护理
thoracolumbar fracture
surgical treatment
perioperative period
early recovery after surgery nursing
conventional nursing
