Evidence-based control of stress response on intraoperative physiological indexes and recovery of patients undergoing gastrointestinal surgery  

作　　者：Chen-Dong Yuan Bao-Zhu Zhou Ning-Yan Wang Qing-Qing Wan Zhen-Zhen Hu 

机构地区：[1]Department of General Surgery,The First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China [2]Department of Anesthesiology,The First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China

出　　处：《World Journal of Gastroenterology》2025年第8期72-81,共10页世界胃肠病学杂志(英文)

摘　　要：BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound hea

关 键 词：Older adult patients Gastrointestinal surgery Stress response Evidence-based nursing Enhanced recovery after surgery 

分 类 号：R614[医药卫生—麻醉学]