[1]李碧波,刘涛,李娜.加速康复外科理念在行脊柱融合术腰椎退行性疾病患者护理中的应用[J].新乡医学院学报,2022,39(11):1068-1073.[doi:10.7683/xxyxyxb.2022.11.014]
　LI Bibo,LIU Tao,LI Na.Application of enhanced recovery after surgery in nursing of patients with lumbar degenerative diseases undergoing spinal fusion[J].Journal of Xinxiang Medical University,2022,39(11):1068-1073.[doi:10.7683/xxyxyxb.2022.11.014]
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加速康复外科理念在行脊柱融合术腰椎退行性疾病患者护理中的应用
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年11
页码:
1068-1073
栏目:
护理研究
出版日期:
2022-11-05

文章信息/Info

Title:
Application of enhanced recovery after surgery in nursing of patients with lumbar degenerative diseases undergoing spinal fusion
作者:
李碧波; 刘涛; 李娜
（新乡市中心医院骨科，河南　新乡　453000）
Author(s):
LI Bibo; LIU Tao; LI Na
（Department of Orthopaedics,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China）
关键词:
腰椎退行性疾病; 加速康复外科; 脊柱融合术
Keywords:
lumbar degenerative diseases; enhanced recovery after surgery; spinal fusion
分类号:
R687.3
DOI:
10.7683/xxyxyxb.2022.11.014
文献标志码:
A
摘要:
目的　探讨加速康复外科（ERAS）理念在行脊柱融合术腰椎退行性疾病手术患者护理中的应用效果。方法　选择2019年1月至2021年12月新乡市中心医院收治的96例腰椎退行性疾病患者为研究对象，所有患者行脊柱融合术，采用随机数字表法将患者分为观察组和对照组，每组48例。围手术期，对照组患者给予常规护理干预，观察组患者给予ERAS护理干预。记录2组患者的手术时间、术中出血量、首次下床时间、住院时间及术后并发症。分别于麻醉清醒后、术后第2天采用视觉模拟评分法（VAS）评估患者的疼痛程度；干预前、术后第7天，采用日本骨科学会（JOA）腰椎功能评分量表评估患者的腰椎功能，采用Oswestry功能障碍指数（ODI）评估患者的腰椎功能障碍情况，采用焦虑自评量表（SAS）评估患者的焦虑症状；术后第7天采用自制护理质量量表评估2组的护理质量。结果　2组患者的手术时间、术中出血量比较差异无统计学意义（P>0.05），观察组患者的首次下床时间和住院时间显著短于对照组（P<0.05）。2组患者术后第2天VAS评分显著低于麻醉清醒后（P<0.05），麻醉清醒后、术后第2天观察组患者VAS评分均显著低于对照组（P<0.05）。干预前2组患者腰椎功能JOA、ODI、SAS评分比较差异无统计学意义（P>0.05）；与干预前比较，术后第7天2组患者腰椎功能JOA评分显著升高，ODI、SAS评分显著降低（P<0.05）；术后第7天，观察组患者腰椎功能JOA评分显著高于对照组，ODI、SAS评分显著低于对照组（P<0.05）。观察组护理质量总分及健康教育、护理态度、责任心、专业技能、心理护理评分均显著高于对照组（P<0.05）。观察组和对照组患者并发症发生率分别为2.08%（1/48）、16.67%（8/48），观察组患者并发症发生率显著低于对照组（χ2=4.414，P<0.05）。结论　ERAS理念在腰椎退行性疾病手术患者护理中具有良好的应用效果，可提高护理质量，有效减轻术后疼痛，促进腰椎功能恢复，降低并发症发生率。
Abstract:
Objective　To investigate the effect of enhanced recovery after surgery (ERAS) in nursing of patients with lumbar degenerative diseases undergoing spinal fusion.Methods　A total of 96 patients with lumbar degenerative diseases admitted to Xinxiang Central Hospital from January 2019 to December 2021 were selected as the study subjects.All patients underwent spinal fusion.The patients were divided into observation group and control group by random number table method,with 48 patients in each group.During the perioperative period,the patients in the control group were given routine care,and the patients in the observation group were given ERAS care.The operation time,intraoperative bleeding,the time of getting out of bed for the first time,hospitalization time and postoperative complications of patients in the two groups were recorded.The pain degree of patients was evaluated by visual analogue scale (VAS) after anesthesia and on the 2nd day after operation.At the time points of before intervention and on the 7th day after operation,the patients′ lumbar function was evaluated by the Japanese Orthopedic Association (JOA) lumbar function rating scale,the patients′ lumbar dysfunction was evaluated by the Oswestry disability index (ODI),and the patients′ anxiety symptoms were evaluated with the self-rating anxiety scale (SAS).The nursing quality was evaluated by self-made nursing quality scale on the 7th day after operation.Results　There was no significant difference in the operation time and intraoperative bleeding between the two groups (P>0.05).The time of getting out of bed for the first time and the hospitalization time of patients in the observation group were significantly shorter than those in the control group (P<0.05).The VAS score of patients in both groups on the 2nd day after operation was significantly lower than that after anesthesia (P<0.05).The VAS score of patients in the observation group was significantly lower than that in the control group after anesthesia and on the 2nd day after operation (P<0.05).There was no significant difference in the JOA score,ODI score and SAS score of lumbar function between the two groups before intervention(P>0.05).Compared with before intervention,the JOA score of lumbar function in the two groups increased significantly,while the ODI score and SAS score decreased significantly on the 7th day after operation (P<0.05).On the 7th day after operation,the JOA score of lumbar function in the observation group was significantly higher than that in the control group,while the ODI score and SAS score were significantly lower than those in the control group (P<0.05).The total score of nursing quality and the scores of health education,nursing attitude,responsibility,professional skills and psychological nursing score in the observation group were significantly higher than those in the control group (P<0.05).The incidence of complications in the observation group and the control group was 2.08% (1/48) and 16.67% (8/48),respectively.The incidence of complications in the observation group was significantly lower than that in the control group (χ2=4.414,P<0.05).Conclusion　ERAS has a good application effect in the nursing of patients with lumbar degenerative diseases,which can improve the quality of care,effectively reduce postoperative pain,promote the recovery of lumbar function,and reduce the incidence of complications.

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更新日期/Last Update: 2022-11-05