加速康复外科理念对OSAHS患者围手术期护理效果的影响  

Effect of Enhance Recovery After Surgery on Perioperative Nursing of Patients With OSAHS

作　　者：刘礼英 郭巧玲[2] 洪志聪[2] LIU Liying;GUO Qiaoling;HONG Zhicong(Day Surgery Center Ward,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China;Department of Otolaryngology-Head and Neck Surgery,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院日间手术中心病房,福建厦门361003 [2]厦门大学附属第一医院耳鼻咽喉头颈外科,福建厦门361003

出　　处：《中国卫生标准管理》2023年第16期154-158,共5页China Health Standard Management

基　　金：福建省自然科学基金项目(2021J011361)。

摘　　要：目的分析基于加速康复外科(enhance recovery after surgery,ERAS)理念的护理对成人阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者围手术期护理效果的影响。方法选取厦门大学附属第一医院耳鼻咽喉头颈外科2022年1—9月收治的78例OSAHS患者为研究对象,分为对照组和ERAS组,每组39例。患者均进行悬雍垂腭咽成型术,部分伴有舌根肥厚的患者同时行舌根等离子射频消融术。ERAS组患者在围手术期进行基于ERAS理念的护理,对照组患者则采取常规围手术期护理。比较两组术后并发症、咽部视觉模拟评分法(visual analogue scale,VAS)、术后住院时间以及患者护理满意度间的差异。结果两组患者术后并发症发生率均较低,偶见恶心呕吐和伤口感染;术后12 h,第2、3、5天ERAS组咽部VAS评分低于对照组,差异有统计学意义(P<0.05)。ERAS组术后出院时间短于对照组,差异有统计学意义(P<0.01)。ERAS组患者护理满意度优于对照组,差异有统计学意义(P<0.05)。结论OSAHS患者行悬雍垂腭咽成型术围手术期采用基于ERAS理念的护理可有效减轻术后咽部疼痛,加快康复进程,缩短术后住院时间,提高患者护理满意度。Objective To analyze the effect of nursing based on enhance recovery after surgery(ERAS)on the perioperative nursing of adult patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 78 adult patients with OSAHS admitted to the department of otolaryngology-head and neck surgery of the First Affiliated Hospital of Xiamen University from January to September 2022 were selected as the study subjects.They were divided into control group and ERAS group,with 39 cases in each group.All patients underwent uvulopalatopharyngoplasty,and some patients with hypertrophy of the tongue root underwent radiofrequency ablation of the tongue root.The patients in ERAS group received perioperative nursing based on ERAS,while the patients in control group received routine perioperative nursing.The differences of postoperative complications,pharyngeal visual analogue scale(VAS),postoperative hospital stay and patient satisfaction were compared between the two groups.Results The incidence of postoperative complications in the two groups was low,nausea,vomiting and wound infection were occasionally seen,and the VAS score of pharyngeal pain in ERAS group was lower than that in the control group 12 hours,the second,third and fifth days after surgery,with statistically significant differences(P<0.05).The time of discharge after surgery in ERAS group was shorter than that in control group,with statistically significant differences(P<0.01).The nursing satisfaction of ERAS group was significantly better than that of the control group(P<0.05).Conclusion The perioperative nursing based on ERAS concept for patients with OSAHS undergoing uvulopalatopharyngoplasty can effectively reduce postoperative pharyngeal pain,accelerate the rehabilitation process,shorten postoperative hospital stay,and improve patient satisfaction.

关 键 词：加速康复外科 阻塞性睡眠呼吸暂停低通气综合征 悬雍垂腭咽成型术 护理效果 术后并发症 围手术期护理 

分 类 号：R473[医药卫生—护理学]