基于多学科合作的专科ERAS护理对瓣膜置换术患者疗效的影响  

Analysis of curative effect of specialist ERAS nursing based on multidisciplinary cooperation on patients undergoing valve replacement surgery

作　　者：罗姣[1] 卢欣欢[1] 黄灵[1] 谢艳华[1] 陈楚容 刘俐俐 孙菁 Luo Jiao;Lu Xinhuan;Huang Ling;Xie Yanhua;Chen Churong;Liu Lili;Sun Jing(Department of Cardiac Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning530021,China)

机构地区：[1]广西医科大学第一附属医院心脏外科,南宁530021

出　　处：《广西医科大学学报》2021年第2期418-422,F0003,共6页Journal of Guangxi Medical University

基　　金：广西高等教育本科教学改革工程项目(No.2017JGB186)。

摘　　要：目的:探讨基于多学科合作的专科加速康复外科(ERAS)护理对瓣膜置换术患者疗效的影响。方法:收集2018年1月至2019年2月在广西医科大学第一附属医院就医并接受心脏外科心脏瓣膜置换术治疗的110例患者,随机分为观察组和对照组,每组55例。观察组采用专科ERAS护理,对照组则采用常规护理,对两组围术期相关的临床资料、生活质量评分表(QOL)、并发症状况、护理满意度情况进行对比分析。结果:观察组的首次下床时间、首次排气时间、首次排便时间、CSICU观察天数、住院天数、住院费用等明显短于或少于对照组(均P<0.05);治疗后,两组患者的生活自理、疲乏、运动、疼痛、食欲、睡眠评分较治疗前明显上升,且观察组患者的以上各项评分均明显高于对照组(均P<0.05);观察组患者术后切口感染、肺部感染、腹胀、新发心房颤动等并发症的总发生率为10.90%,明显低于对照组的38.18%(P<0.05);观察组出院时满意度显著高于对照组(P<0.05)。结论:基于多学科合作的专科ERAS护理干预可促进患者术后恢复,加快患者康复速度,提高患者生存质量,减少并发症,提高患者护理满意度,具有较高的临床推广价值。Objective: To explore the impact of specialist accelerated rehabilitation surgery(ERAS) nursing based on multidisciplinary cooperation on the efficacy of valve replacement patients. Methods: The subjects of the study were 110 patients who were treated by the First Affiliated Hospital of Guangxi Medical University from January 2018 to February 2019 and received heart valve replacement in the heart surgery of the hospital. After a simple randomization method, the subjects were equally classified into control group and observation group. During the perioperative period, subjects in the observation group were treated with specialized ERAS care, while those in the control group were treated with routine care. Based on perioperative data, quality of life scale(QOL),complication status, and nursing satisfaction, a comparative analysis of the two groups of subjects was carried out. Results: The observation group was significantly shorter or less than the control group in terms of perioperative indicators such as the first time to get out of bed, first exhaust time, first defecation time, CSICU observation days, hospitalization days, and hospitalization expenses(P<0.05). After treatment, the scores of self-care, fatigue, exercise, pain, appetite, and sleep of the two groups of patients were significantly higher than those before treatment, and the scores of the observation group were significantly higher than those of the control group(P<0.05). The total incidence of postoperative wound infection, lung infection, abdominal distension, new atrial fibrillation and other complications in the observation group was 10.90%, which was significantly lower than that(38.18%) in the control group(P<0.05).The satisfaction degree of the observation group at discharge was significantly higher than that of the control group(P<0.05). Conclusion: Specialist ERAS nursing intervention based on multidisciplinary cooperation can promote postoperative recovery of patients, speed up patient recovery, and improve the patient’s quality of life,

关 键 词：心脏外科 瓣膜置换术 多学科 加速康复外科 预后 

分 类 号：R473.6[医药卫生—护理学]