基于ERAS理念的干预路径在重度脊柱侧凸畸形患者围术期的应用  

Application of ERAS-based clinical intervention path to patients with severe scoliosis during perioperative period

作　　者：廖冬花 沈思思 左铭君 龚阳琪 高碧蓉 LIAO Donghua;SHEN Sisi;ZUO Mingjun(Xinhua Hospital Affiliated to Medical College of Shanghai Jiao Tong University,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院,上海市200092

出　　处：《河北医药》2023年第14期2222-2225,共4页Hebei Medical Journal

基　　金：上海新华医院院级护理创新项目(编号:xhhlcx2020-09)。

摘　　要：目的探讨基于加速康复外科(ERAS)理念的临床干预路径在重度脊柱侧凸畸形患者围手术期的应用效果。方法本研究为回顾性研究,收集新华医院2021年6至8月治疗的55例重度脊柱侧凸患者临床资料,患者围手术期给予常规措施干预,将其纳入对照组,干预4周;另收集医院2021年9至11月治疗的55例重度脊柱侧凸畸形患者临床资料,患者在常规措施基础上给予基于ERAS理念的临床护理路径干预,纳入试验组干预4周。对比2组患者手术指标(手术时间、麻醉苏醒时间、术中出血量及术中低体温发生率)、麻醉舒适度[围手术期麻醉舒适度调查问卷(PCQ)评分]、并发症发生率以及生活质量[脊柱侧凸研究学会22项问卷表(SRS-22)评分]。结果试验组麻醉苏醒时间短于对照组,术中低体温发生率低于对照组,差异有统计学意义(P<0.05);2组手术时间、术中出血量比较,差异无统计学意义(P>0.05);试验组PCQ评分高于对照组,差异有统计学意义(P<0.05);干预4周,2组SRS-22评分均较干预前升高,且试验组高于对照组,差异有统计学意义(P<0.05);试验组并发症发生率略低于对照组,差异无统计学意义(P>0.05)。结论基于ERAS理念的临床护理路径运用在重度脊柱侧凸畸形患者中可缩短患者的麻醉苏醒时间,降低术中低体温发生率,提高麻醉舒适度和生活质量。Objective To explore the application effect of clinical nursing path based on the concept of enhanced recovery after surgery(ERAS)in the perioperative period on patients with severe scoliosis.Methods It was a retrospective study.Patients(n=55)with severe scoliosis who were treated in Xinhua Hospital from June 2021 to August 2021,and managed by 4-week routine intervention during the perioperative period were included in the control group.Another patients(n=55)with severe scoliosis treated in ourhospital from September 2021 to November 2021,who were given ERAS-based nursing path intervention combined with routine nursing for 4 weeks were included in the experimental group.The operation indexes(operation time,anesthesia awakening time,intraoperative blood loss and the incidence of intraoperative hypothermia),anesthesia comfort(Psychological Captical Questionnaire[PCQ]scores in the perioperative period),complication rate and the quality of life(Scoliosis Resarch Society questionnaire-22[SRS-22]score)were compared between groups.Results The anesthesia awakening time in the experimental group was significantly shorter than that in the control group,and the incidence of hypothermia during operation was significantly lower(P<0.05).There were no significant differences in operation time and intraoperative bleeding between groups(P>0.05).The PCQ score of the experimental group was significantly higher than that of the control group(P<0.05).After 4 weeks of intervention,the SRS-22 scores of both groups were significantly higher than those before intervention,which were significantly higher in the experimental group than those of the control group(P<0.05).The incidence of complications in the experimental group was slightly lower than that in the control group without a significant difference(P>0.05).Conclusion The application of ERAS-based clinical nursing path in patients with severe scoliosis can shorten the anesthesia awakening time,reduce the incidence of hypothermia during operation,and improve the comfort of anesthesi

关 键 词：重度脊柱侧凸 快速康复外科 临床护理路径 围手术期 

分 类 号：R473.6[医药卫生—护理学]