摘要
目的探讨基于加速康复外科(enhanced recovery after surgery,ERAS)理念的达芬奇机器人肝切除术临床护理路径在改善患者术后恢复质量及降低围手术期并发症发生率的效果。方法选取2022年7月至2023年6月盐城市第一人民医院收治的36例行达芬奇机器人肝切除术的患者作为研究对象,将2022年7—12月收治的患者纳入对照组,2023年1—6月收治的患者纳入实验组,每组18例。对照组采用常规临床护理,实验组采用ERAS临床护理路径。比较两组术后恢复质量、围手术期并发症发生率及舒适度情况。结果实验组术后首次进食时间、首次下床活动时间、首次排气时间、腹腔引流时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。实验组并发症发生率低于对照组,但两组比较差异无统计学意义。术前2 h及术后2 h,实验组口渴、饥饿发生率均低于对照组,差异有统计学意义(P<0.05);术后6、24 h,两组口渴、饥饿发生率比较差异无统计学意义;术前1 d及术后1、2 d,实验组睡眠障碍发生率均低于对照组,差异有统计学意义(P<0.05)。结论基于ERAS理念的达芬奇机器人肝切除术临床护理路径可显著改善患者术后恢复状况,减少围手术期并发症发生,提高患者舒适度。
Objective To investigate the effect of clinical nursing pathway for Da Vinci robotic hepatectomy based on the concept of enhanced recovery after surgery(ERAS)on improving patients'postoperative recovery quality and reducing the incidence of perioperative complications.Methods A total of 36 patients who underwent Da Vinci robotic hepatectomy in Yancheng NO.1 People's Hospital from July 2022 to June 2023 were selected as the research subjects,patients admitted from July to December 2022 were included in the control group,and those admitted from January to June 2023 were included in the experimental group,with 18 cases in each group.The control group received conventional clinical care,and the experimental group received the ERAS clinical nursing pathway.The postoperative recovery quality,the incidence of perioperative complications and the comfort level were compared between the two groups.Results The time of the first meal after the surgery,the time of the first out-of-bed activity,the time of the first exhaust,the time of abdominal drainage and the hospital stay in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the experimental group was lower than that in the control group,but the difference was not statistically significant.At 2 h before surgery and 2 h after surgery,the incidence of thirst and hunger in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05);there were no statistically significant differences in the incidence of thirst and hunger between the two groups at 6 and 24 h after surgery;at 1 d before surgery and 1,2 d after surgery,the incidence of sleep disturbance in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The application of clinical nursing pathway in Da Vinci robotic hepatectomy based on the concept of ERAS can improve the quality of postoperative recovery,reduce the occurrence of perioperative complications and improve patients'comfort.
作者
应杰萍
朱素文
周勇
YING Jieping;ZHU Suwen;ZHOU Yong(Department of Hepatobiliary and Pancreatic Surgery,Yancheng NO.1 people's Hospital,Yancheng,Jiangsu,224000,China;Department of General Surgery,Yancheng NO.1 people's Hospital,Yancheng,Jiangsu,224000,China)
出处
《当代医学》
2025年第14期177-182,共6页
Contemporary Medicine
关键词
加速康复外科
临床护理路径
达芬奇机器人手术
肝切除术
Enhanced recovery after surgery
Clinical nursing pathway
Da Vinci robotic hepatectomy
Hepatectomy
