术后加速康复在妇科腹腔镜手术患者中的应用  

Application of enhanced recovery after surgery for patients undergoing gynecologic laparoscopy

作　　者：王远 李晶晶[1] 刘月伟 高晓薇[1] 张继敏 WANG Yuan;LI Jingjing;LIU Yuewei;GAO Xiaowei;ZHANG Jimin(Hysteroscopy Center,Fuxing Hospital Capital Medical University,Beijing,100038)

机构地区：[1]首都医科大学附属复兴医院宫腔镜中心,北京100038

出　　处：《中西医结合护理》2022年第12期253-257,共5页Chinese Journal of Integrative Nursing

摘　　要：目的探讨术后加速康复(ERAS)在妇科腹腔镜手术患者中的应用效果。方法回顾性收集2020年7月—2021年6月医院妇科行腹腔镜手术治疗的患者87例。2020年7月—2020年12月收治的45例患者为对照组,2021年1月—6月收治的42例患者为ERAS组。对照组实施常规围手术期护理干预,ERAS组实施基于ERAS的护理干预。记录两组患者术中相关指标:者手术时间、术中出血量和血红蛋白(Hb)减少量,术后相关指标:术后首次下床活动时间、肛门排气时间、住院时间、术后12 h疼痛视觉模拟评分(VAS),以及术后并发症(恶心呕吐、肩颈酸痛、腹胀)发生情况。结果ERAS组手术时间短于对照组,差异有统计学意义(P<0.05)。ERAS组术后肛门排气时间、术后首次下床活动时间和住院时间短于对照组,术后12 h的VAS评分低于对照组,差异有统计学意义(P<0.01)。ERAS组术后恶心呕吐、肩膀酸痛和腹胀的发生率低于对照组,差异有统计学意义(P<0.05)。结论给予妇科腹腔镜手术患者ERAS快速康复护理,能够有效促进患者术后康复时间,降低术后疼痛和并发症发生风险,缩短患者住院时间。Objective To explore the application effect of enhanced recovery after surgery(EARS)in gynecological laparoscopy.Methods Totally 87 patients who underwent gynecologi⁃cal laparoscopy were retrospectively analyzed.According to the sequence of hospital admissions,45 patients in control group received routine perioperative care,and another 42 patients in ERAS group were given EARS-based nursing interventions.Primary outcomes included intraoperative indexes(operation time,intraoperative blood loss and decrease in hemoglobin,postoperative in⁃dexes(first time of postoperative off-bed activities,anus exhausting time,length of stay,Visual Analogue Scale on pain at 12 hours after surgery)and postoperative complications such as nausea and vomiting,should and neck pain,abdominal distension.Results The operation time in the ERAS group was shorter than that in the control group(P<0.05).Patients in the ERAS group had shorter first time of postoperative off-bed activities,anus exhausting time,length of stay,and lower score of VAS pain at 12 hours after surgery compared with those in the control group(P<0.01).Incidences of nausea and vomiting,should and neck pain,abdominal distension in the ERAS group were lower than those in the control group(P<0.05).Conclusion The EARS-based nursing is potentially effective to improve the postoperative recovery of patients who under⁃went gynecological laparoscopy,it may reduce the postoperative pain and complications,and shorten the length of stay of patients.

关 键 词：术后加速康复 妇科 腹腔镜手术 疼痛 围手术期护理 

分 类 号：R473.6[医药卫生—护理学]