基于ERAS-MDT模式的护理干预在腹壁切口疝腹腔镜手术中的应用  

Application of nursing intervention based on ERAS-MDT modelin laparoscopic abdominal incision hernia surgery

作　　者：赖丽雅 范栩妃[1] 陈吉彩[1] 吴大洲[1] LAI Liya;FAN Xufei;CHEN Jicai;WU Dazhou(Department of Hernia and Abdominal Wall Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第一医院疝与腹壁外科,浙江温州325000

出　　处：《中华全科医学》2025年第5期886-889,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金项目(LY20H030003);温州市科技计划项目(Y20220112)。

摘　　要：目的 探讨加速康复外科(ERAS)-多学科协作(MDT)模式的护理干预方案对腹壁切口疝腹腔镜手术患者的影响,旨在改善患者预后,促进快速康复。方法 采用随机数字表法将2022年1月—2024年1月于温州医科大学附属第一医院拟行腹腔镜下补片修补术治疗的110例腹壁切口疝患者分为对照组和观察组,每组55例,分别给予常规护理干预、基于ERAS-MDT模式的护理干预,比较2组患者术后恢复相关指标、住院费用、疼痛评分、焦虑情况、睡眠质量、不良事件发生率及护理满意度。结果 观察组术后肛门排气时间为(6.99±1.11)h,首次进食时间为(9.31±1.02)h,下床活动时间为(9.45±1.24)h,住院时间为(6.77±1.01)d,均短于对照组的(9.23±1.37)h、(11.45±1.34)h、(12.56±2.09)h及(8.45±1.47)d(P<0.05),住院费用少于对照组(P<0.05);术后第1、3、5天VAS评分低于对照组(P<0.05);焦虑量表(SAI)评分、匹兹堡睡眠质量指数(PSQI)评分均低于对照组(P<0.05);不良事件发生率低于对照组(P<0.05);护理满意度评分高于对照组(P<0.05)。结论 给予腹壁切口疝腹腔镜手术患者基于ERAS-MDT模式的护理干预,可有效缓解患者术后疼痛程度,改善患者焦虑和睡眠质量,降低术后不良事件发生风险,减少住院费用,促进患者早日康复。Objective To investigate the effectiveness of ERAS combined with multidisciplinary collaboration(MDT)nursing intervention in improving postoperative outcomes in patients undergoing laparoscopic abdominal incision hernia surgery.Methods A total of 110 patients scheduled for laparoscopic patch repair of abdominal incision hernia at the First Affiliated Hospital of Wenzhou Medical University from January 2022 to January 2024 were enrolled.Patients were randomly divided into a control group and an observation group,with 55 cases in each group.The two groups were given routine nursing intervention and nursing intervention based on ERAS-MDT model,respectively.Postoperative recovery indexes,hospitalization costs,pain scores,anxiety,sleep quality,incidence of adverse events,and nursing satisfaction were compared between the two groups.Results In the observation group,the time of anal exhaust after operation[(6.99±1.11)h],the time of first feeding[(9.31±1.02)h],the time of getting out of bed[(9.45±1.24)h],and the time of hospitalization[(6.77±1.01)day]were shorter than those in the control group[(9.23±1.37)h,(11.45±1.34)h,(12.56±2.09)h,and(8.45±1.47)d,respectively(P<0.05)].The hospitalization cost was also lower than that in the control group(P<0.05).The VAS scores at days 1,3,and 5 after surgery were lower than those in the control group(P<0.05).The scores of anxiety scale(SAI)and Pittsburgh sleep quality index(PSQI)were lower than those in the control group,respectively(P<0.05).Additionally,the incidence of adverse events was lower than that in the control group(P<0.05).While the nursing satisfaction score was higher than that in the control group(P<0.05).Conclusion Nursing intervention based on ERAS-MDT model can relieve postoperative pain,improve anxiety and sleep quality of patients,reduce the risk of adverse events,reduce hospitalization costs,and promote early recovery of patients after laparoscopic abdominal incision hernia surgery.

关 键 词：腹壁切口疝 加速康复外科 多学科协作 围手术期护理 预后 

分 类 号：R656.2[医药卫生—外科学] R473.6[医药卫生—临床医学]