加速康复外科在脑胶质瘤患者围术期护理中的应用  

Application of enhanced recovery after surgery in the perioperative nursing of cerebral glioma patients

作　　者：赵彬芳[1] 贺世明[1] 王元[1] 李明娟[1] 杨丽辉 赵艾[2] Zhao Binfang;He Shiming;Wang Yuan;Li Mingjuan;Yang Lihui;Zhao Ai(Department of Neurosurgery, Tang Du Hospital, the Fourth Military Medical University, Xi＇an 710038, China;Department of Nursing, Tang Du Hospital, the Fourth Military Medical University, Xi＇an 710038, Chin)

机构地区：[1]第四军医大学唐都医院神经外科,西安710038 [2]第四军医大学唐都医院护理部,西安710038

出　　处：《中华现代护理杂志》2018年第12期1454-1457,共4页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金面上项目（81572470）

摘　　要：目的 探讨加速康复外科（enhanced recovery after surgery，ERAS）理念在脑胶质瘤患者围术期护理中应用的安全性及有效性。方法 参照其他专科领域的加速康复护理措施，结合神经外科特点，制定其ERAS护理优化措施。选择第四军医大学唐都医院神经外科2016 年6 月—2017 年4 月收治的80 例同期住院的脑胶质瘤患者，按入院注册的随机数字编号经由“信封法”随机分为对照组40 例和观察组40 例。对照组采用常规护理方法，观察组应用ERAS 护理优化措施进行护理。比较两组患者术后并发症、护理满意度、术后早期进食时间、拔除尿管时间、下床活动时间、停止输液时间和住院时间的差异。结果 两组患者并发症发生情况差异无统计学意义（P ＞ 0.05），观察组护理满意度为82.5%，对照组为62.5%，差异有统计学意义（P＜ 0.05）。观察组术后24 h 内拔除尿管率为85.0%，对照组为25.0%，差异有统计学意义（P＜ 0.05）。观察组术后3 d内下床活动率为95.0%，对照组为30.0%，差异有统计学意义（P ＜ 0.05）。观察组患者的术后首次进食水时间、停止输液时间和住院时间均短于对照组，两组比较差异均有统计学意义（P＜ 0.05）。结论 应用ERAS理念实施脑胶质瘤患者的围术期护理是安全有效的，能够加速术后康复，缩短住院时间，降低住院费用。Objective To explore the safety and effectiveness of enhanced recovery after surgery （ERAS） in the perioperative nursing of cerebral glioma patients. Methods ERAS optimized nursing was developed based on ERAS of other specialties combined with neurosurgical features. A total of 80 cerebral glioma patients recruited in the Department of Neurosurgery of Tang Du Hospital from June 2016 to April 2017 were investigated and divided into the experimental group（ 40 cases） and control group（ 40 cases） using the envelope random sampling with the registration number assigned when a patient was admitted to the hospital. Patients in the control group were treated with routine treatment, while patients in the experimental group received the ERAS nursing. The complications, nursing satisfaction rate, the time of taking food, removing urine tube, stopping the infusion and hospital stay were compared between two groups. Results There was no significant difference in the occurrence of complications between two groups（ P〉 0.05）. The nursing satisfaction rate was 82.5% in the experimental group and 62.5% in the control group with significant difference between two groups（ P〈 0.05）. The rate of removing urine tube within 24 hours after surgery was 85.0% in the experimental group and 25.0% in the control group; the bed activity rates within 3 days after surgery in the experimental and control groups were 95.0% and 30.0% respectively; the differences between two groups were statistically significant（ P〈 0.05）. The time of taking food, stopping the infusion and hospital stay in the experimental group were significantly shorter than those of the control group（ P〈 0.05）. Conclusions The application of ERAS in the perioperative nursing of cerebral glioma patients is safe and effective, which allows faster rehabilitation, and reduces postoperative hospital stay and hospitalization costs.

关 键 词：神经胶质瘤 围手术期护理 加速康复外科 

分 类 号：R473.73[医药卫生—护理学]