摘要
目的探讨加速康复外科(EARS)理念护理模式对急性A型主动脉夹层(ATAAD)患者的作用效果。方法选取在2020年6月至2022年10月于河南省胸科医院心血管外科接受手术治疗的68例ATAAD患者为研究对象,按照随机数字表法分为常规组(34例)和研究组(34例),常规组接受常规护理,研究组在常规组基础上接受ERAS理念护理模式,对比两组患者术后负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分]、疼痛程度[视觉模拟评分(VAS)]、谵妄发生情况、认知功能[简易智能精神状态检查量表(MMSE)评分]、肺功能[氧合指数、用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))]及恢复情况[重症监护室(ICU)停留时间、住院时间]。结果研究组患者干预后的SAS、SDS、VAS评分和术后谵妄的总发生率均低于常规组(P<0.05);与常规组比较,研究组术后7 d MMSE评分及氧合指数、FVC水平、FEV_(1)水平均升高(P<0.05),ICU停留时间、住院时间均缩短(P<0.05)。结论EARS理念护理模式干预能够改善ATAAD患者术后负性情绪和肺功能,降低谵妄发生,促进术后恢复。
Objective To explore the effect of enhanced recovery after surgery(EARS)concept nursing mode in patients with acute type A aortic dissection(ATAAD)after operation.Methods A total of 68 patients with ATAAD who received surgical treatment in cardiovascular surgery of Henan Provincial Chest Hospital from June 2020 to October 2022 were selected as the study subjects.They were divided into the routine group(34 cases)and the study group(34 cases)according to the random number table method.The routine group was given routine nursing,and the study group implemented EARS concept nursing mode on the basis of the routine group.The negative emotions[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],pain degree[(visual analogue scale)VAS],delirium occurrence,cognitive function[mini-mental state examination(MMSE)score],lung function[oxygenation index,forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1))]and recovery[intensive care unit(ICU)dwell time,hospitalization time]of the patients in the two groups after operation were compared.Results The SAS,SDS,VAS scores and the total incidence of postoperative delirium in the study group were significantly lower than those in the routine group(P<0.05).Compared with the routine group,the MMSE score,the oxygenation index,FVC and FEV_(1) on the 7th day after operation of the study group were increased(P<0.05),while the stay time in ICU and hospital stay were shortened(P<0.05).Conclusion EARS concept nursing model intervention can improve the negative mood and pulmonary function of patients with ATAAD after operation,reduce the incidence of delirium,and promote postoperative recovery.
作者
冯丽
孟晓妹
李丹
王晶
FENG Li;MENG Xiaomei;LI Dan;WANG Jing(Ward 49 of Department of Cardiovascular Surgery,Henan Provincial Chest Hospital/Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
2023年第24期4579-4583,共5页
Henan Medical Research
关键词
急性A型主动脉夹层
加速康复外科
负性情绪
谵妄
肺功能
acute type A aortic dissection
enhanced accelerated recovery surgery
negative emotions
delirium
pulmonary function
