加速康复外科护理模式在经尿道输尿管镜钬激光碎石术围手术期的应用效果  

Application effect of ERAS-derived nursing interventions in the perioperative period of ureteroscopic holmium laser lithotripsy

作　　者：马瑾 李娅洁 李静竹 杨媛 MA Jin;LI Ya-jie;LI Jing-zhu;YANG Yuan(Department of Digestive,Endocrinology and Hematology,Hospital of the 75th Army of PLA,Yunnan Province,Dali 671003,China;Department of Nursing,Hospital of the 75th Army of PLA,Yunnan Province,Dali 671003,China;Department of Cardiology and Nephrology,Hospital of the 75th Army of PLA,Yunnan Province,Dali 671003,China;Department of Disease Control and Prevention,Hospital of the 75th Army of PLA,Yunnan Province,Dali 671003,China)

机构地区：[1]陆军第75集团军医院消化血液内分泌科,云南大理671003 [2]陆军第75集团军医院护理部,云南大理671003 [3]陆军第75集团军医院心肾内科,云南大理671003 [4]陆军第75集团军医院疾病预防控制科,云南大理671003

出　　处：《中国当代医药》2021年第27期273-276,共4页China Modern Medicine

摘　　要：目的探讨加速康复外科(ERAS)护理模式应用于经尿道输尿管镜钬激光碎石术围手术期的临床效果。方法选取2017年7月至2019年1月陆军第75集团军医院住院治疗的96例输尿管结石患者作为研究对象,采用掷硬币法将其分为研究组(n=46)和对照组(n=50)。研究组采用ERAS护理模式,对照组采用传统护理模式。比较两组的手术持续时间、术后肛门首次排气时间、术后出现并发症例数、住院天数、住院总费用、术后炎症和组织损伤标志物、数字疼痛评定量表(NRS)评分、日常生活能力评定量表(ADL)评分和对责任护士工作的满意度评分。结果研究组的术后肛门首次排气时间、术后6和24 h的NRS评分、术后第1天晨起静脉血白细胞计数及C反应蛋白浓度、术后住院天数和住院总费用低于对照组,差异均有统计学意义(P<0.05)。研究组术后24 h的ADL评分和对责任护士工作的满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论经尿道输尿管镜钬激光碎石术围手术期实施ERAS护理模式能显著加快患者康复,促进医患和谐,值得临床推广。Objective To investigate the clinical effect of implementing the ERAS-derived nursing interventions during the perioperative period of ureteroscopic holmium laser lithotripsy.Methods A total of 96 patients with ureteral stones hospitalized in the Hospital of the 75th Army of PLA from July 2017 to January 2019 were selected as study subjects.They were divided into the study group(n=46)and the control group(n=50)by coin toss method.The study group received the ERAS-derived nursing interventions and the control group received the traditional nursing interventions.Terms of surgical duration,the time of first anal exhaust after surgery,postoperative complications,length of stay,total hospital expenses,the concentrations of markers of inflammation and tissue damage,the pain scores after surgery(NRS),the score of daily living ability(ADL),and the satisfaction scores for responsible nurses between two groups were compared.Results The time of first anal exhaust after surgery,the NRS scores at 6 and 24 h after surgery,the white blood cell counts and the concentration of c-reactive protein of venous blood,the postoperative hospitalization days and the total hospitalization expenses of patients in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The scores of ADL and the satisfaction scores of responsible nurses in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion Implementing the ERAS-derived nursing interventions during the perioperative period of ureteroscopic holmium laser lithotripsy can significantly accelerate the recovery of patients and promote the harmony between doctors and patients,which is worthy of clinical promotion.

关 键 词：加速康复外科 输尿管结石 输尿管镜 钬激光 炎症反应 满意度 

分 类 号：R473[医药卫生—护理学]