ERAS理念在经鼻蝶入路垂体瘤切除术患者围术期护理中的应用
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摘要
目的:探讨快速康复外科(ERAS)理念在经鼻蝶入路垂体瘤切除术患者围术期护理中的应用方法与效果。方法:将79例经鼻蝶入路垂体瘤切除术患者按入院单双日分为观察组45例和对照组34例,对照组采用常规护理措施,观察组在常规护理基础上应用ERAS理念进行护理。比较两组患者术后并发症、住院时间、住院费用及护理满意率。结果:观察组患者术后一过性尿崩症发生率低于对照组,护理满意率高于对照组,住院时间、住院费用少于对照组,两组比较差异均有统计学意义(P<0.05)。结论:ERAS理念应用于经鼻蝶入路垂体瘤切除术患者,可缩短住院时间,降低并发症发生率,促进患者术后康复。
Objective:To explore the application method and effect of ERAS in perioperative nursing of patients with endonasal transsphenoidal hypophysoma resection.Methods:A total of 79 patients with endonasal transsphenoidal hypophysoma resection were divided into observation group(n=45)and control group(n=34)according to the admission date.The control group received conventional nursing measures,and the observation group received conventional nursing with ERAS concept.Postoperative complications,hospitalization time,hospitalization cost and nursing satisfaction rate were compared between the two groups.Results:The incidence of postoperative transient diabetes insipidus in the observation group was lower than that in the control group,the rate of nursing satisfaction was higher than that in the control group,and the length of hospital stay and hospitalization cost were less than that in the control group.The differences between the two groups were statistically significant(P<0.05).Conclusion:The application of ERAS in perioperative nursing of patients with endonasal transsphenoidal hypophysoma resection can shorten the hospital stay,reduce the incidence of complications and promote postoperative rehabilitation.
Objective:To explore the application method and effect of ERAS in perioperative nursing of patients with endonasal transsphenoidal hypophysoma resection.Methods:A total of 79 patients with endonasal transsphenoidal hypophysoma resection were divided into observation group(n=45)and control group(n=34)according to the admission date.The control group received conventional nursing measures,and the observation group received conventional nursing with ERAS concept.Postoperative complications,hospitalization time,hospitalization cost and nursing satisfaction rate were compared between the two groups.Results:The incidence of postoperative transient diabetes insipidus in the observation group was lower than that in the control group,the rate of nursing satisfaction was higher than that in the control group,and the length of hospital stay and hospitalization cost were less than that in the control group.The differences between the two groups were statistically significant(P<0.05).Conclusion:The application of ERAS in perioperative nursing of patients with endonasal transsphenoidal hypophysoma resection can shorten the hospital stay,reduce the incidence of complications and promote postoperative rehabilitation.
引文
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[3] Nygren J,Thacker J,Carli F,et al.Guidelines for perioperative care in elective rectal/pelvic surgery:Enhanced Recovery After Surgery(ERAS)Society recommendations[J].World J Surg,2013,37(2):285-305.
[4] Sinha A,Jayaraman L,Punhani D.Efficacy of ultrasound-guided transversus abdominis plane block after laparoscopic bariatric surgery:a double blind,randomized,controlled study[J].Obes Surg,2013,23(4):548-553.
[5] Kehlet H,Wilmore DW.Evidence-based surgical care and the evolution of fast-track surgery[J].Ann Surg,2008,248(2):189-198.
[6] Nygren J,Soop M,Thorell A,et al.Preoperative oral carbohydrate administration reduces postoperative insulin resistance[J].Clin Nutr,1998,17(2):65-71.
[7] Svanfeldt M,Thorell A,Hausel J,et al.Randomized clinical trial of the effect of preoperative oral carbohydrate treatment on postoperative whole-body protein and glucose kinetics[J].Br J Surg,2007,94(11):1342-1350.
[8] Breuer JP,von Dossow V,von Heymann C,et al.Preoperative oral carbohydrate administration to ASA Ⅲ-Ⅳ patients undergoing elective cardiac surgery[J].Anesth Analg,2006,103(5):1099-1108.
[9] Vlug MS,Wind J,Hollmann MW,et al.Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery:a randomized clinical trial(LAFA-study)[J].Ann Surg,2011,254(6):868-875.
[10] Smart NJ,White P,Allison AS,et al.Deviation and failure of enhanced recovery after surgery following laparoscopic colorectal surgery:early prediction model[J].Colorectal Dis,2012,14(10):e727-e734.