快速康复外科理念的舒适化手术室护理对腰椎退行性疾病患者术后谵妄的影响  

Effect of comfortable operating room nursing based on enhanced recovery after surgery concept on postoperative delirium in patients with lumbar degenerative disease

作　　者：杨嵩萍 袁茜 殷雪群[1] 张新梅[1] 杨云 YANG Songping;YUAN Qian;YIN Xuequn;ZHANG Xinmei;YANG Yun(The First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院麻醉手术科,江苏省苏州市215000

出　　处：《护理实践与研究》2024年第8期1260-1264,F0003,共6页Nursing Practice and Research

基　　金：江苏省卫生健康委员会老年健康科研项目(编号:LX2021011)。

摘　　要：目的分析在腰椎退行性疾病手术中实施基于快速康复外科(ERAS)理念的舒适化手术室护理的效果及对其术后谵妄的影响。方法选择2021年5月—2023年3月医院接受手术治疗的腰椎退行性疾病患者103例作为研究对象,按照组间基本特征具有可比性的原则分为对照组52例和观察组51例。对照组行常规手术室护理,观察组在对照组基础上行基于ERAS理念的舒适化手术室护理,比较两组患者术后麻醉苏醒情况、谵妄发生风险和疼痛情况,并统计两组术中并发症和术后谵妄发生情况。结果观察组患者术后自主呼吸恢复时间、意识恢复时间和完全清醒时间均短于对照组,差异有统计学意义(P<0.05)。双因素重复测量方差分析结果显示,术后24 h、术后48 h两组患者3D-CAM评分、VAS评分均较术后12 h降低,不同时间比较差异有统计学意义(P时间<0.05),术后24 h、术后48 h观察组3D-CAM评分、VAS评分低于对照组,差异有统计学意义(P组间<0.05),随着观察时间延长,3D-CAM组间随时间变化差异减小,VAS术后48 h差异减小,差异有统计学意义(P交互<0.05)。观察组术中并发症总发生率和术后谵妄发生率低于对照组,差异有统计学意义(P<0.05)。结论基于ERAS理念的舒适化手术室护理可有效提高腰椎退行性疾病手术患者术后麻醉苏醒质量和效率,减轻术后疼痛,减少术中不良反应的发生,进而有效地降低其术后谵妄风险。Objective To analyze the effect of comfortable operating room nursing based on enhanced recovery after surgery(ERAS)concept in lumbar degenerative disease surgery and its impact on postoperative delirium.Methods A total of 103 patients with lumbar degenerative diseases who received surgical treatment in the hospital from May 2021 to March 2023 were selected as research subjects and divided into a control group(52 cases)and an observation group(51 cases)according to the principle of comparability of basic characteristics between groups.The control group received conventional operating room nursing,and the observation group received comfortable operating room nursing based on the ERAS concept on the basis of the control group.The postoperative anesthesia recovery,delirium risk and pain of the two groups were compared,and the intraoperative complications and postoperative delirium were statistically analyzed.Results The postoperative spontaneous breathing recovery time,consciousness recovery time and full awakening time of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).The results of two-way repeated measures analysis of variance showed that the 3D-CAM scores and VAS scores of the two groups were lower at 24 h and 48 h after surgery than those at 12 h after surgery,and the differences were statistically significant at different times;with the extension of observation time(P<0.05),the 3D-CAM and VAS scores of patients at 24 h and 48 h after surgery in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05),the difference of 3D-CAM between the groups decreased over time,and the difference of VAS decreased at 48 h after surgery,the difference was statistically significant(P<0.05).The incidence of intraoperative complications and incidence of postoperative delirium in the observation group were lower than those in the control group,the differences were statistically significant(P

关 键 词：快速康复外科理念 舒适护理 手术室护理 腰椎退行性疾病 谵妄 

分 类 号：R473.6[医药卫生—护理学]