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作 者:谢文广 张超[1] 刘晓玉[4] 舒越 毕蒙蒙 杨鑫晨 邓玉璐 李欢 XIE Wen-guang;ZHANG Chao;LIU Xiao-yu;SHU Yue;BI Meng-meng;YANG Xin-chen;DENG Yu-lu;LI Huan(Department of Nursing,the Second Affiliated Hospital of Nanchang University;Department of Comprehensive Intervention,the Second Affiliated Hospital of Nanchang University;Department of Neurosurgery,the Second Affiliated Hospital of Nanchang University;School of Nursing,Nanchang University,Nanchang 330006,China)
机构地区:[1]南昌大学第二附属医院护理部,南昌330006 [2]南昌大学第二附属医院综合介入室,南昌330006 [3]南昌大学第二附属医院神经外科,南昌330006 [4]南昌大学护理学院,南昌330006
出 处:《实用临床医学(江西)》2023年第6期65-69,共5页Practical Clinical Medicine
基 金:江西省科技厅重点研发计划一般项目(20202BBGL73072)。
摘 要:目的探讨基于预康复理念的术前管理策略在未破裂颅内动脉瘤(UIA)患者围手术期的应用效果。方法选取2021年2月至2022年8月于南昌大学第二附属医院神经外科住院并择期手术的UIA患者100例,随机分为观察组和对照组,各50例。对照组接受常规术前护理,观察组在对照组的基础上实施预康复术前管理策略。比较2组术后首次下床活动时间和术后住院时间,干预前和手术后第3天的焦虑抑郁情况[使用医院焦虑抑郁量表(HADS)评价]和营养状况[使用营养风险筛查工具(NRS2002)评价]以及手术后并发症的发生率。结果干预前,2组HADS和NRS2002评分比较差异无统计学意义(P>0.05);术后第3天,观察组HADS评分和NRS2002评分显著低于对照组(P<0.05或P<0.001)。观察组手术后首次下床活动时间和术后住院时间均短于对照组(均P<0.001)且观察组并发症发生率亦显著小于对照组(P=0.048)。结论基于预康复理念的术前管理策略有助于加快UIA患者术后康复进程,改善其术后心理和营养状态,减少术后住院时间和并发症的发生率。Objective To explore the efficacy of preoperative management strategy based on the concept of pre-rehabilitation in patients with unruptured intracranial aneurysm(UIA)during perioperative period.Methods One hundred patients admitted to the Department of Neurosurgery of the Second Affiliated Hospital of Nanchang University from February 2021 to August 2022 for elective UIA surgery were randomly divided into two groups,with 50 patients in each group.The control group only received routine preoperative care,while the observation group implemented preoperative management strategy based on the concept of pre-rehabilitation.The time to off-bed activity,length of hospital stay and incidence of postoperative complications were compared between the two groups.The psychological and nutritional statuses were assessed by using the Hospital Anxiety and Depression Scale(HADS)and the Nutritional Risk Screening 2002(NRS2002),respectively.Results There were no significant differences in the scores of HADS and NRS2002 between the two groups before intervention(P>0.05).On the third day after operation,both HADS and NRS2002 scores in the observation group were lower than those in the control group(P<0.05 or P<0.001).In addition,compared with the control group,the time to off-bed activity and the length of hospital stay were shortened(P<0.001),and the incidence of postoperative complications was reduced in the observation group(P=0.048).Conclusion Preoperative management strategy based on pre-rehabilitation concept can promote postoperative rehabilitation,improve psychological and nutritional status,and reduce hospital stay and complications in UIA patients.
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