多学科模式下ERAS干预联合家庭协同护理对子宫肌瘤全子宫切除术患者的影响  

Effect of ERAS Intervention Combined with Home Collaborative Nursing Mode in Multidisciplinary Model in Patients with Total Hysterectomy for Uterine Fibroids

作　　者：刘慧苹 邢冉 彭毅萍 Liu Huiping;Xing Ran;Peng Yiping(The Third Affiliated Hospital of Henan TCM University,Zhengzhou Henan 450000,China)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450000

出　　处：《齐鲁护理杂志》2023年第20期16-18,共3页Journal of Qilu Nursing

基　　金：河南省中医药科学研究专项课题(编号:2022ZY2038)。

摘　　要：目的:探讨多学科模式下加速康复外科(ERAS)干预联合家庭协同护理对子宫肌瘤全子宫切除术患者的影响。方法:将2019年7月1日~2022年7月31日行全子宫切除术的92例子宫肌瘤患者随机分为实验组和对照组各46例,对照组采取多学科模式下ERAS干预措施,实验组在对照组基础上联合家庭协同护理。比较两组术后恢复情况,干预前后自我效能[采用一般自我效能感量表(GSES)],术前和术后7 d应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)、血管紧张素Ⅱ(ATⅡ)、促肾上腺皮质激素(ACTH)]情况。结果:实验组术后胃肠道功能恢复时间、首次下床活动时间、住院时间均短于对照组(P<0.01),住院费用低于对照组(P<0.01);干预后,实验组GSES各维度评分及总分均高于对照组(P<0.05);术后7 d,实验组Cor、NE、ATⅡ、ACTH应激反应指标均低于对照组(P<0.01)。结论:多学科模式下ERAS干预联合家庭协同护理对子宫肌瘤全子宫切除术患者术后恢复、自我效能、应激反应均具有积极影响。Objective:To explore the effect of ERAS intervention combined with home collaborative nursing mode in patients with total hysterectomy for uterine fibroids in a multidisciplinary model.Methods:A total of 92 patients with hysteromyoma admitted from July 1,2019 to July 31,2022 who underwent total hysterectomy were randomly divided into the experimental group and the control group with 46 patients in each group.The control group received ERAS intervention in multidisciplinary mode,and the experimental group was given family collaborative nursing model.The postoperative recovery,self-efficacy by GSES and preoperative and postoperative 7 d stress response indicators such as Cor,NE,ATⅡand ACTH between the two groups were compared.Results:The gastrointestinal function recovery tim,the ambulation time,length of stay were shorter in the experimental group than those in the control group(P<0.01),and hospitalization costs in the experimental group were significantly lower than those in the control group(P<0.01).After intervention,the GSES scores an total scores in the experimental group were higher than those in the control group(P<0.05).After treatment of 7 d,the Cor,NE,ACTH and ATⅡstress response indicators were significantly lower than those in the control group.Conclusion:ERAS intervention combined with family collaborative nursing under the multidisciplinary model has positive effect on postoperative recovery,self-efficacy and stress response in patients with total hysterectomy for uterine fibroids.

关 键 词：子宫肌瘤 全子宫切除术 家庭协同护理 加速康复外科 应激反应 

分 类 号：R473.71[医药卫生—护理学]