基于加速康复外科理念的临床护理路径对手术室输尿管软镜碎石术患者生理应激反应的影响  

Effect of Clinical Nursing Pathway Based on the Concept of Accelerated Rehabilitation Surgery on Physiological Stress Response of Patients Undergoing Ureteroscopic Lithotripsy in Operating Room

作　　者：郭果 曹娟[2] GUO Guo;CAO Juan(Department of Operation Room,Nanyang Hospital of Traditional Chinese Medicine,Nanyang Henan 473000,China;Department of Obstetrics and Gynecology,The Second People's Hospital of Nanyang City,Nanyang Henan 473000,China)

机构地区：[1]南阳市中医院手术室,河南南阳473000 [2]南阳市第二人民医院妇产科监护室,河南南阳473000

出　　处：《临床研究》2023年第4期135-138,共4页Clinical Research

摘　　要：目的 探讨基于加速康复外科理念(ERAS)的临床护理路径对手术室输尿管软镜碎石术(FURL)患者生理应激反应的影响。方法 选取2019年10月至2020年10月南阳市中医院收治的96例行FURL患者,采用简单随机分组,将患者分为观察组(N=48)和对照组(N=48)。对照组采用常规手术室FURL护理方法,观察组在对照组的基础上,采用基于ERAS的临床护理路径,比较两组围术期相关指标、生理应激反应、围术期疼痛评分和并发症。结果 在围术期,观察组患者手术时间、第一次排气时间、术后下床时间和出院时间均短于对照组,差异有统计学意义(P<0.05)。干预后,观察组和对照组心率(HR)、收缩压(SBP)、舒张压(DBP)等应激反应指标均低于干预前,均处于临床正常范围内,且观察组低于对照组,差异有统计学意义(P<0.05)。在术后12 h、术后24 h和术后48 h,观察组患者的VAS评分均低于对照组,差异有统计学意义(P<0.05)。干预后,观察组和对照组发热、输尿管损伤、感染和出血发生率差异无统计学意义(P>0.05)。结论 基于ERAS的临床护理路径可以有效降低行FURL患者的生理应激反应和疼痛感,促进术后机体功能的恢复。Objective To explore the effect of clinical nursing pathway based on enhanced recovery after surgery(ERAS)on physiological stress reaction of patients undergoing flexible ureteroscopic lithotripsy(FURL)in operating room.Methods A total of 96 patients who underwent FURL in Nanyang Hospital of Traditional Chinese Medicine from October 2019 to October 2020 were selected and divided into observation group(N=48)and control group(N=48)by simple random grouping.FURL nursing method was used in the conventional operating room in the control group,and clinical nursing route based on ERAS was used in the observation group on the basis of the control group,and perioperative related indicators,physiological stress response,perioperative pain score and complications were compared between the two groups.Results In the perioperative period,the operation time,first exhaust time,postoperative getting out of bed time and discharge time of the observation group were shorter than those of the control group,the difference was statistically significant(P<0.05).After intervention,stress response indexes such as heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the observation group and control group were all lower than before intervention,within the clinical normal range,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).At 12 h,24 h and 48 h after surgery,VAS scores of observation group were lower than those of control group,and the difference was statistically significant(P<0.05).After intervention,there was no significant difference in the incidence of fever,ureteral injury,infection and bleeding between the observation group and the control group(P>0.05).Conclusion The clinical nursing pathway based on ERAS can effectively reduce the physiological stress response and pain of FURL patients and promote the recovery of body function after the operation.

关 键 词：加速康复外科理念 临床护理路径 输尿管软镜碎石术 生理应激反应 

分 类 号：R473[医药卫生—护理学]