加速康复外科理念下的术中与术后管理模式在单侧椎板入路双侧椎管减压术患者中的应用效果分析  

Analysis of the effect of intraoperative and postoperative management mode guided by the concept of enhanced recovery after surgery in patients undergoing unilateral laminotomy for bilateral decompression

作　　者：刘绍侠 何茵[2] 刘颖[1] 马芳[3] 唐家广 Liu Shaoxia;He Yin;Liu Ying;Ma Fang;Tang Jiaguang(Department of Anesthesiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China;Department of Critical Care Medicine,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China;Operating Room,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China;Department of Orthopedics,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,北京100176 [2]首都医科大学附属北京同仁医院重症医学科,北京100176 [3]首都医科大学附属北京同仁医院手术室,北京100176 [4]首都医科大学附属北京同仁医院骨科,北京100176

出　　处：《中国医刊》2025年第1期57-60,共4页Chinese Journal of Medicine

基　　金：北京市医院管理中心临床技术创新项目(XMLX202104)。

摘　　要：目的分析加速康复外科(ERAS)理念下的术中与术后管理模式在单侧椎板入路双侧椎管减压术(ULBD)患者中的应用效果。方法选取2019年1月至2021年6月首都医科大学附属北京同仁医院收治的96例接受ULBD治疗的青年腰椎间盘突出症患者为研究对象,采用随机数字表法分为对照组和观察组,每组48例。对照组给予常规护理干预,观察组在对照组的基础上给予ERAS理念下的术中与术后管理模式干预。比较分析两组患者术后12、24、48、72 h的疼痛程度。比较分析两组患者的术后恢复指标(引流管拔除时间、排气时间、排便时间、下床活动时间、住院时间)、苏醒期躁动及术后并发症发生情况、满意度。结果术后12、24 h,两组患者的视觉模拟评分法(VAS)评分比较差异均无统计学意义(P>0.05);术后48、72 h,观察组患者的VAS评分低于对照组,差异均有统计学意义(P<0.05)。观察组患者的引流管拔除时间、排气时间、排便时间、下床活动时间、住院时间、苏醒期躁动发生率及术后并发症总发生率均短于或低于对照组,差异均有统计学意义(P<0.05)。观察组患者的总满意率高于对照组,差异有统计学意义(P<0.05)。结论ERAS理念下的术中与术后管理模式可有效减轻ULBD术后患者的疼痛程度,降低苏醒期躁动及术后并发症发生风险,加快患者的术后康复进程,且可显著提高患者的满意度。Objective To analyze the effect of intraoperative and postoperative management model guided by the concept of enhanced recovery after surgery(ERAS)in patients undergoing unilateral laminotomy for bilateral decompression(ULBD).Method 96 young patients with lumbar disc herniation receiving ULBD admitted to Beijing Tongren Hospital,Capital Medical University from January 2019 to June 2021 were selected as the study objects,and they were divided into control group and observation group by random number table method,with 48 cases in each group.The control group was given routine nursing intervention,and the observation group was given intraoperative and postoperative management mode intervention guided by the concept of ERAS on the basis of the control group.The pain degree in the two groups 12,24,48,72 h after surgery was compared and analyzed.The postoperative recovery indexes(drainage tube removal time,exhaust time,defecation time,getting out of bed time,hospital stay time),emergence agitation,postoperative complications and satisfaction in the two groups were compared and analyzed.Result At 12,24 h after surgery,there were no significant differences in VAS scores between the two groups(P>0.05).At 48,72 h after surgery,the VAS scores in observation group were lower than those in control group,with statistical significance(P<0.05).Drainage tube removal time,exhaust time,defecation time,getting out of bed time,hospital stay time,incidence of emergence agitation and total incidence of postoperative complications in observation group were shorter or lower than those in control group,with statistical significance(P<0.05).The total satisfaction rate in observation group was higher than that in control group,with statistical significance(P<0.05).Conclusion The intraoperative and postoperative management model guided by the ERAS concept can effectively reduce the pain degree of ULBD patients,and reduce the risk of emergence agitation and postoperative complications,and accelerate the postoperative rehabilitation proces

关 键 词：腰椎间盘突出症 单侧椎板入路双侧椎管减压术 加速康复外科 

分 类 号：R473.6[医药卫生—护理学]