摘要
目的:观察基于加速康复外科(ERAS)理念的临床护理路径(CNP)在输尿管软镜碎石术患者中的应用效果。方法:回顾性分析2020年2月至2023年1月于该院行输尿管软镜碎石术的162例患者的临床资料,按照护理方法不同将其分为研究组和对照组各81例。对照组实施常规护理,研究组在对照组基础上实施基于ERAS理念的CNP,比较两组围术期指标(肛门首次排气时间、进食时间、首次下床活动时间和住院时间)水平、手术前后炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平、护理前后负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]评分,以及并发症发生率。结果:研究组肛门首次排气时间、进食时间、首次下床活动时间和住院时间均短于对照组,差异有统计学意义(P<0.05);术后1 d,研究组TNF-α、IL-6、CRP水平均低于对照组,差异有统计学意义(P<0.05);护理后,研究组SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为6.17%(5/81),低于对照组的18.52%(15/81),差异有统计学意义(P<0.05)。结论:基于ERAS理念的CNP应用于输尿管软镜碎石术患者可优化围术期指标水平,降低炎性因子水平、负性情绪评分和并发症发生率,效果优于常规护理。
Objective:To observe application effects of clinical nursing pathway(CNP)based on concept of enhanced recovery after surgery(ERAS)in patients undergoing flexible ureteroscopic lithotripsy.Methods:The clinical data of 162 patients who underwent flexible ureteroscopic lithotripsy in this hospital from February 2020 to January 2023 were retrospectively analyzed.According to different nursing methods,they were divided into study group and control group,81 cases in each group.The control group was given routine nursing,while the study group was given CNP based on concept of ERAS on the basis of that of the control group.The perioperative indexes(the first anal exhaust time,feeding time,the first ambulation time and hospitalization time),the levels of inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]before and after the surgery,the scores of negative emotions[self-rating anxiety scale(SAS),self-rating depression scale(SDS)]before and after the nursing,and the incidence of complications were compared between the two groups.Results:The first anal exhaust time,the feeding time,the first ambulation time and the hospitalization time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).One day after the surgery,the levels of TNF-α,IL-6 and CRP in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the nursing,the scores of SAS and SDS in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was 6.17%(5/81),which was lower than 18.52%(15/81)in the control group,and the difference was statistically significant(P<0.05).Conclusions:CNP based on concept of ERAS in the patients undergoing flexible ureteroscopic lithotripsy can optimize the perioperative index levels,reduce the levels of inflammatory factors,the negative emotion scores and the incidence of complications.Moreover,it is superior to the routine nursing.
作者
张宝玉
张丽丽
李晓敏
Zhang Baoyu;Zhang Lili;Li Xiaomin(Operating Room of Affiliated Hospital of Xinyang Vocational and Technical College,Xinyang 464000 Henan,China)
出处
《中国民康医学》
2024年第3期156-159,共4页
Medical Journal of Chinese People’s Health
关键词
加速康复外科
临床护理路径
输尿管软镜碎石术
炎性因子
负性情绪
并发症
Enhanced recovery after surgery
Clinical nursing pathway
Flexible ureteroscopic lithotripsy
Inflammatory factor
Negative emotion
Complication
