| Background:The idea of enhanced recovery after surgery(ERAS)or fast-track surgery(FTS)was first proposed by Kehlet Henrik,a Danish surgeon.The central idea is to improve procedures of microinvasive operation,anesthesia and perioperative period nursing by taking a series of aggressive interventions which could minimize the surgical injury and relieve patients’ stress reaction so as to shorten the postoperative hospitalization,reduce the hospital costs and improve satisfaction of patients.Perioperative care is an integral part of the concept of ERAS,but also the embodiment of regarding the patient as the center.Starting from September 2015,based on ERAS theory and the advanced experiences from Sir Run Run Shaw Hospital thoracic surgery,the department of thoracic surgery in our hospital has carried a series of improvement measures including preoperative education,pain control,preoperative and postoperative work of breathing training and standard application of drug killer,which has obtained satisfactory results.Objective:Explore the effect of applying the new nursing intervention in perioperative period lung cancer patients based on enhanced recovery after surgery(ERAS).Methods:Retrospective analysis 337cases of patients with lung cancer from July 2014 to June 2016 in the department of thoracic surgery in a major hospital,including 168 cases of lung cancer patients adopted the traditional nursing methods(group A),169 patients with lung cancer patients adopted ERAS nursing treatment(group B).Respectively analysis patients general information,hospital stay,hospitalization expenses,postoperative complications,postoperative intestinal peristalsis recovery time and lung function indices.Questionnaire survey was used to review nursing satisfaction.SPSS 17.0 was adopted for data analyse.Comparing the incidence of postoperative complications,postoperative intestinal peristalsis recovery time,hospital stay,hospitalization expenses,one-week pain score and nursing satisfactionbetween group A and group B.Patients of group B used the device of respiratory function training to training their respiratory function,and then compare the differences of lung function including maximal voluntary ventilation(MVV),forced vital capacity(FVC)and forced expiratory volume in first second(FEV1)between pre-admission and pre-operation.Results:(1)Two groups of patients in the preoperative general information,pathological results,preoperative basic diseases,accumulation of the lesion part and TNM staging had no statistical significance(P>0.05).(2)Group B had statistically significant lower complication rate,shorten postoperative hospitalization and less hospital costs than group A(P<0.05).(3)One-week pain score was identified as the worst pain in the last 24 hours.The results showed that there was no statistical significance of the first day and the six hours after the operation pain score(NRS)between the two groups(P>0.05),the second to fifth day of the NRS scores of group B were significantly lower than that of group A(P<0.05).(4)Group B had a shorten intestinal peristalsis recovery time which was statistically significant(P<0.05).(5)Nursing satisfaction score in group B was obviously higher than that of group A which was statistically significant(P<0.05).(6)Group B had a significant better index in pulmonary function tests compared pre-operative with pre-admission which was statistically significant(P<0.05).Conclusion:For the patients of lung resection of thoracic surgery,the usage of new nursing intervention measures based on ERAS during postoperative period could promote patient’s tolerance of lung surgery,reduce the postoperative pain as well as the incidence of postoperative complications.Also,it could promote the early recovery of gastrointestinal function,reduce hospitalization expenses and improve nursing satisfaction,thus finally promote the recovery of the patients. |
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