Enhanced Recovery After Surgery In The Perioperative Nursing Of Patients With Biliary Exploration

Objective:This paper is to explore the application effect of enhanced recovery after surgery(ERAS)in perioperative nursing of patients with choledocholithotomy,and to provide theoretical basis and practical experience for the perioperative nursing of such patients in the future.Methods:From March to December 2018,96 patients with choledocholithiasis or endoscopic choledocholithotomy for gallstones in the Department of Hepatobiliary Surgery,from Affiliated Hospital of Yan’an University were selected.According to the method of random number table,48 patients in the experimental group and 48 in the control group were randomly selected.Patients in the control group were given routine treatment.On the basis of routine nursing,patients in the experimental group were treated with perioperative management of ERAS.The scores of self-rating anxiety scale(SAS)before and after surgery were compared between the two groups.After the ERAS intervention,the pain scales scores,the indwelling time of pipeline(gastrointestinal decompression tube,urinary catheter,and abdominal drainage tube),the first exhaust time after operation,the first time of getting out of bed,postoperative complications,hospitalization time,hospitalization cost were analyzed statistically,and a comparative study was carried out.Results:There was no significant difference in anxiety score between the experimental group and the control group on admission(P>0.05).The anxiety score of the experimental group was significantly lower than that of the control group 1 day before and 3 days after surgery(P<0.001).The pain of incision in the experimental group was lower than that of the control group at 24 h,48 h and 72 h after operation,and the difference was statistically significant(P<0.05).In the experimental group,the indwelling time of postoperative gastrointestinal decompression tube and catheter indwelling time were 2.78±0.62 h and 4.00±0.93 h,while in the control group,the indwelling time of postoperative gastrointestinal decompression tube and catheter indwelling time were 9.29±2.16 h and 20.25±6.95 h.The difference between the two groups was statistically significant.In the experimental group,the indwelling time of the abdominal drainage tube was 36.50±4.96 h,which was significantly different from that in the control group(50.79±2.73 h).In addition,the first exhaust time,the first time out of bed and the incidence of postoperative complications in the experimental group were 25.67±3.96 h,16.25±3.22 h,and 8.3%,respectively,which were significantly different(P<0.05),compared with those in the control group(36.75±2.45 h,28.88±1.85 h and 43.8%).The hospitalization time of the experimental group is 7.79±0.98 days,which was significantly lower than that of the control group(13.17 ± 1.93 days),and the hospitalization cost was 1.34±0.73(ten thousand yuan),which was lower than that of the control group(1.51±0.56(ten thousand yuan))and the difference was statistically significant(P<0.01).Conclusion:The application of ERAS concept in perioperative patients with choledocholi--thotomy can alleviate the perioperative anxiety,relieve the pain and promote the recovery of patients.