ERAS在胸腰椎骨折合并神经损伤患者围手术期的效果观察  

Effects of ERAS in the perioperative period of patients with thoracolumbar spinalfracture and nerve injury

作　　者：薛小红 杭国珍 谈海萍 刘克洪[2] XUE Xiaohong;HANG Guozhen;TAN Haiping;LIU Kehong(Department of Orthopaedics,Chinese People’s Armed Police Force Coast Guard Corps Hospital,Jiaxing 314000,Zhejiang,China;Department of Orthopaedics,Zhejiang Provincial Corps Hospital of the Chinese People’s Armed Police Force,Jiaxing 314000,Zhejiang,China)

机构地区：[1]中国人民武装警察部队海警总队医院骨科,浙江嘉兴314000 [2]中国人民武装警察部队浙江省总队医院骨科,浙江嘉兴314000

出　　处：《中国现代医生》2023年第23期84-87,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2020KY776)。

摘　　要：目的 观察加速康复外科(enhancd recovery after surgry,ERAS)模式对胸腰椎骨折合并神经损伤手术患者心境状态、康复进程的影响。方法 选取2019年6月至2021年6月海警医院收治的92例胸腰椎骨折合并神经损伤患者,采用随机数字表法分为对照组(n=46)和观察组(n=46)。对照组给予常规护理,观察组在对照组的基础上采取ERAS模式护理。比较两组简明心境状态量表(profile of mood states,POMS)评分、视觉模拟评分法(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestrydisabilityindex,ODI)评分、并发症发生情况及胃肠、膀胱功能。结果 术后6h和出院时,观察组的POMS评分、VAS评分均显著低于对照组(P<0.05),且均显著低于入院时(P<0.05)。出院时两组ODI评分比较,差异均无统计学意义(P>0.05),但均显著低于入院时(P<0.05)。观察组首次排气时间、首次排便时间、首次反射排尿时间及膀胱功能重建时间均显著短于对照组(P<0.05);观察组并发症发生率显著低于对照组(P<0.05)。结论 ERAS模式可降低胸腰椎骨折合并神经损伤患者并发症发生率,缓解疼痛,改善心境状态,缩短康复进程。Objective To observe the effect of enhancd recovery after surgry(ERAS)model on the state of mind and recovery process of patient undergoing surgery for thoracolumbar spinal fracture and nerve injury.Methods A total of 92 patients with thoracolumbar vertebral fracture and nerve injury admitted to the Coast Guard Hospital from June 2019 to June 2021 were selected and divided into the control group(n=46)and the observation group(n=46)according to the method of random number table.The control group was given conventional nursing care,and the observation group adopted ERAS mode nursing care on the basis of the control group.The two groups were compared in terms of profile of mood states(POMS)scores,visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,complication occurrence and gastrointestinal and bladder function.Results The POMS score and VAS score of the observation group were significantly lower than those of the control group at 6 hours postoperatively and at discharge(P<0.05),and both were significantly lower than those at the time of admission(P<0.05).The difference in ODI scores between the two groups at discharge was not statistically significant(P>0.05),but was significantly lower than at admission(P<0.05).The time of the first defecation,the time of the first defecation,the time of the first reflex voiding and the time of the reconstruction of the bladder function of the observation group were significantly shorter than those of the control group(P<0.05);and the rate of the complications of the observation group was significantly lower than that of the control group(P<0.05).Conclusion The ERAS mode can reduce the incidence of complications in patients with thoracolumbar fractures and nerve injury,relieve pain,improve mood,restore nerve function,and shorten the rehabilitation process.

关 键 词：胸腰椎骨折 神经损伤 围手术期 加速康复外科 

分 类 号：R473.6[医药卫生—护理学]