加速康复外科理念下无缝隙护理方案在机器人辅助经椎间孔腰椎椎间融合术中的应用  

Application of seamless nursing protocol under ERAS principles in robot-assisted transforaminal lumbar interbody fusion

作　　者：张敏[1] 郭佳 ZHANG Min;GUO Jia(Department of Orthopedics,Baoji Central Hospital,Baoji 721008,China)

机构地区：[1]宝鸡市中心医院骨科,陕西宝鸡721008

出　　处：《机器人外科学杂志(中英文)》2025年第4期567-571,共5页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发项目(2021SF-353)。

摘　　要：目的:分析加速康复外科(ERAS)理念下无缝隙护理方案在接受机器人辅助经椎间孔腰椎椎间融合术(TLIF)患者中的应用。方法:回顾性分析2023年3月—2024年4月宝鸡市中心医院收治的行机器人辅助TLIF 150例患者的临床资料。采用随机数表法,将其分为对照组(75例,常规护理)与干预组(75例,ERAS理念下无缝隙护理联合常规护理)。比较两组患者手术时间、术中出血量、术中输液量、首次下床时间、住院天数、术后不同时间段疼痛情况以及干预前、后的心理状态、功能状态、生活质量。结果:与对照组相比,干预组首次下床时间、住院时间更短,术后12~72 h疼痛数字(NRS)评分更低(P<0.05)。术后3 d,干预组负性情绪评分更低(P<0.05)。术后30 d干预组日本骨科协会评估治疗分数(JOA)、心理、身体、社会关系评分更低(P<0.05)。结论:对于接受机器人辅助TLIF治疗的患者,ERAS理念下无缝隙护理模式可提升其康复效率、促进功能恢复、缓解术后疼痛、改善患者负性情绪与生活质量。Objective:To evaluate the application effect of seamless nursing protocol under the Enhanced Recovery after Surgery(ERAS)concept in patients undergoing robot-assisted transforaminal lumbar interbody fusion(TLIF).Methods:A retrospective analysis was conducted on 150 patients who underwent robot-assisted TLIF at Baoji Central Hospital from March 2023 to April 2024.They were randomly divided into the control group(n=75,receiving conventional nursing care)and the intervention group(n=75,receiving ERASbased seamless nursing)using a random number table.Operative time,intraoperative blood loss,fluid infusion volume,time to first ambulation,length of hospital stay,postoperative pain intensity at various intervals,and pre-/post-intervention psychological status,functional outcomes,and quality of life.were compared between the two groups of patients.Results:Compared with the control group,the intervention group showed significantly shorter time to first ambulation and reduced length of hospital stay(P<0.05).The intervention group showed significantly lower Numerical Rating Scale(NRS)scores during 12-72 hours postoperatively(P<0.05),reduced negative emotion scores at postoperative day 3(P<0.05),improved Japanese Orthopaedic Association(JOA)scores at 30-day follow-up(P<0.05),and better psychological,physical,and social relationship status compared to the control group(P<0.05).Conclusion:For patients undergoing robot-assisted TLIF,the ERAS-based seamless nursing protocol can enhance rehabilitation efficiency,promote functional recovery,alleviate postoperative pain,and improve emotional well-being and quality of life.

关 键 词：加速康复外科 机器人辅助手术 经椎间孔腰椎椎间融合术 无缝隙护理 

分 类 号：R687.3[医药卫生—骨科学] R473.6[医药卫生—外科学]