快速康复外科理念联合临床路径护理在腰椎间盘突出手术护理中的应用  

Application of enhanced recovery after surgery combined with clinical pathway nursing in postoperative nursing of lumbar disc herniation

作　　者：丁娟 许科峰 陶峰琴[1] 景慧云 邱霞 秦萌涯 DING Juan;XU Kefeng;TAO Fengqin(Orthopedic DistrictⅠ,904th Hospital of the Joint Logistics Support Force of PLA,Jiangsu,Wuxi 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院骨科一区,江苏省无锡市214000 [2]中国人民解放军联勤保障部队第904医院骨科二区,江苏省无锡市214000

出　　处：《河北医药》2023年第6期943-945,共3页Hebei Medical Journal

基　　金：中国科学院战略性科学先导专项项目(编号:XDA16020104)。

摘　　要：目的 研究快速康复外科理念联合临床路径护理在腰椎间盘突出手术患者护理中的临床运用效果。方法 78例腰椎间盘突出手术患者按随机数字表法分成对照组与观察组,每组39例,对照组采取常规护理,观察组采取快速康复外科理念联合临床路径护理,比较2组患者的临床护理效果情况。结果 观察组患者术后垫枕时间、肛门排气时间、下床活动时间、住院时间均少于对照组(P<0.05);2组干预后腰痛评分标准(JOA评分)均高于本组干预前,且观察组干预后JOA评分高于对照组(P<0.05);观察组干预后的步态评分、直腿抬高试验评分、感觉障碍评分、运动障碍评分、日常活动影响评分明显高于对照组(P<0.05)。干预后观察组并发症发生率显著低于对照组(P<0.05)。结论 对腰椎间盘突出手术患者予以快速康复外科理念联合临床路径护理,能促进术后身体的改善,缓解腰痛,并减少并发症的发生,值得大力推广。Objective To observe the effect of applying enhanced recovery after surgery(ERAS)combined with clinical pathway nursing in postoperative nursing of patients with lumbar disc herniation.Methods A total of 78 cases of patients with lumbar disc herniation surgery admitted from February 2021 to January 2022 were randomly assigned to control group(n=39)and observation group(n=39).Conventional nursing care was given to patients of control group,while postoperative nursing based on ERAS combined with clinical pathway nursing was given to those in observation group.Clinical nursing effect of the two groups was compared.Results First time to use postoperative pillow support time,anal exhaust,out-of-bed activities and length of stay in the observation group were significantly shorter than those in the control group(P<0.05).After intervention,the Japanese Orthopaedic Association(JOA)scores were significantly higher in both groups,which were much higher in the observation group than in the control group(P<0.05).Gait score,straight leg elevation test score,sensory impairment score,motor impairment score and daily activity impact score in the observation group were significantly higher than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Postoperative nursing based on ERAS and clinical pathway nursing can promote the improvement of postoperative body,relieve low back pain,and reduce the occurrence of complications in patients treated with lumbar disc herniation surgery,which is worth promoting vigorously.

关 键 词：腰椎间盘突出手术 快速康复外科理念 临床路径护理 JOA评分 症状改善 

分 类 号：R473.6[医药卫生—护理学]