基于加速康复外科理念的护理管理在泌尿外科耻骨上机器人辅助经脐双通道腹腔镜护理中的应用  

Nursing management based on the concept of enhanced recovery after surgery(ERAS)in suprapubic robot-assisted laparoscopic transumbilical doublechannel laparoscopic surgery in urological surgery

作　　者：李莉莉[1] 蒙美英[1] 刘兰英[1] 张国玺[1] 何志华 LI Li-i;MENG Mei-ying;LIU Lan-ying;ZHANG Guo-xi;HE Zhi-hua(Department of Urology,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一附属医院泌尿外科,江西赣州341000

出　　处：《赣南医学院学报》2023年第5期508-512,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省中医药管理局科技计划项目(2021A052);赣州市科技局科技计划项目(GZ2021ZSF093);赣南医学院第一附属医院院级科技计划项目(YJYB202042)。

摘　　要：目的:探讨基于加速康复外科(Enhanced recovery after surgery,ERAS)理念的护理管理在泌尿外科耻骨上机器人辅助腹腔镜经脐双通道腹腔镜围术期护理的应用效果。方法:选取2019年8月至2020年7月于我科采用耻骨上机器人辅助经脐双通道腹腔镜手术40例患者为研究对象。采用随机化分组法分为常规组和试验组各20例。常规组应用传统护理措施,试验组采用基于加速康复外科理念护理措施。对比两组术后恢复情况、并发症发生率及患者满意度。结果:试验组患者平均住院时间、首次肛门排气时间、引流管拔除时间、首次进食时间短于常规组,差异有统计学意义(P<0.05);试验组疼痛评分低于常规组,差异有统计学意义(P<0.05);两组导尿管拔除时间比较,差异无统计学意义(P>0.05);两组围术期低血糖、腹痛腹胀、咳嗽咳痰、深静脉血栓等并发症发生率比较,试验组低于常规组,但差异无统计学意义(P>0.05);两组患者满意度比较,试验组满意度更高,但差异无统计学意义(P>0.05)。结论:应用加速康复外科理念,能够有效加快泌尿外科耻骨上机器人辅助腹腔镜经脐双通道腹腔镜患者康复。Objective:To explore the application effect of enhanced recovery after surgery(ERAS)based nursing management in perioperative nursing of suprapubic robot-assisted laparoscopic transumbilical double-channel laparoscopic surgeryin urological surgery.Methods:Forty patients who underwent suprapubic robot-assisted double-channel laparoscopic surgery in the department of urology,the First Affiliated Hospital of Gannan Medical University from August 2019 to July 2020 were selected.They were divided into conventional groupand experimental grouprandomly,with 20 cases in each group.The conventional group was treated with traditional nursing measures.The experimental group received nursing measures based on the concept of enhanced recovery after surgery.Postoperative recovery,complication rate and patient satisfaction were compared between the two groups.Results:The average hospital stay,first anal exhaust time,drainage tube removal time,first feeding timewere shorter than those in conventional group,the difference was statistically significant(P<0.05);pain score in experimental group were lower than those in conventional group,the difference was statistically significant(P<0.05).There was no significant difference in catheter removal time between the two groups(P>0.05).There were no significant differences in perioperative complications such as hypoglycemia,abdominal pain and distension,cough and sputum,and deep vein thrombosis(P>0.05),but the incidence of complications in the experimental group was lower than that in the conventional group.The patient satisfaction of the experimental group was higher thanthatof the conventional group,but there was no statistical difference(P>0.05).Conclusion:The application of the concept of enhanced recovery after surgery can effectively accelerate the rehabilitation of suprapubic robot-assisted laparoscopic transumbilical double-channel laparoscopic patients in urological surgery.

关 键 词：加速康复外科 机器人手术 耻骨联合 经自然腔道 双通道腹腔镜 护理 

分 类 号：R329.25[医药卫生—人体解剖和组织胚胎学]