| ObjectiveApplying nursing intervention measures guided by concept of enhanced recovery after surgery(ERAS)in perioperative period of patients with cholelithiasis and observing differences in recovery of gastrointestinal function after operation,early ambulation,days of hospitalization,total hospitalization expenses,incidence of complications,pain,anxiety,degree of comfort.To explore the safety,effectiveness and feasibility of this nursing concept in perioperative period of patients with cholelithiasis and provide theoretical basis and clinical experience for the application of this concept in perioperative period of patients with cholelithiasis in the future.MethodsThrough methods of literature reading,nursing group discussion,and pre-testing,the specific nursing intervention measures guided by concept of ERAS were determined.Sixty-eight patients hospitalized in Hepatobiliary Surgery of a 3A grade hospital in Qingdao from July 2016 to June 2017 were included in study by using the method of historical comparative experiment.Thirty-four patients from July 2016 to December 2016 are treated as control group and were given traditional perioperative routing nursing measures.Thirty-four patients from January 2017 to June 2017 were treated as observation group and were given an intervention by using the nursing intervention measures guided by concept of ERAS.The differences in first exhausting time,first defecation time,first drinking time,first time to get out of bed,days of hospitalization,total hospitalization expenses,incidence of complications,pain,anxiety,degree of comfort between the two groups of patients were compared.Results1.In this research,there were 34 patients in observation group,include 18 male and 16 female,and the average age was 54.6±15.4 years old.There were 34 patients in control group,include 21 male and 13 female,and the average age was 56.8±16.0 years old.The research results showed that there was no statistically significant(P>0.05)in basic data between two groups,such as age,sex,education level,occupation,monthly household income,mode of payment,NRS2002 score,admission VAS score,admission SAS score.2.There was statistically significant(P<0.05)in first exhausting time,first defecation time,first drinking time,first time to get out of bed,days of hospitalization after operation and total hospitalization expenses between two groups.There were one case of biliary fistula,one case of incision infection in observation group and one case of biliary fistula,two casesof incision infection,two cases of abdominal infection in control group after operation.There was no statistically significant(P>0.05)in incidence of biliary fistula,incision infection,abdominal infection after operation between two groups.There were two cases of urinary tract infection and one case of pulmonary infection in observation group and six cases of urinary tract infection and four cases of pulmonary infection in control group after operation.There was statistically significant(P<0.05)in incidence of urinary tract infection and pulmonary infection after operation between two groups.3.Variance analysis result of repeated measurements showed that there was statistically significant(P<0.05)in pain score of patients at twenty four hours after operation,forty eight hours after operation and seventy two hours after operation between two groups,and the pain score of observation group was lower than control group.There was statistically significant(P<0.05)in inter group effect and time effect of postoperative pain score between two groups.There was an interaction effect between postoperative pain score and time factor and there was statistically significant(P<0.05)in postoperative pain score and time factor.4.Variance analysis result of repeated measurements showed that there was statistically significant(P<0.05)in anxiety score of patients at twenty four hours after operation,forty eight hours after operation and seventy two hours after operation between two groups,and the anxiety score of observation group was lower than control group.There was statistically significant(P<0.05)in inter group effect and time effect of postoperative anxiety score between two groups.There was an interaction effect between postoperative anxiety score and time factor and there was statistically significant(P<0.05)in postoperative anxiety score and time factor.5.Variance analysis result of repeated measurements showed that comparing of comfort status between observation group and control group in twenty four hours,forty eight hours and seventy two hours after operation,on the time effect,there was statistically significant(P<0.05)in physiological dimension and psychological dimension and there was no statistically significant(P>0.05)in environmental dimension and social dimension.There was statistically significant(P<0.05)in group effect.There was an interaction effect between time and group(P<0.05).ConclusionThe application of the nursing intervention measures guided by concept of ERAS is safe,effective and feasible in perioperative period of patients with cholelithiasis.The nursing intervention measures guided by concept of ERAS can promote early oral eating,promote anal exhaust and gastrointestinal function recovery,promote early ambulation and reduce postoperative complication.The nursing intervention measures guided by concept of ERAS can shorten hospitalization time,reduce hospitalization expenses and promote patient recovery,and also speed up hospital bed turnover rate,save medical and health expenditure,and lay a foundation for rational and efficient utilization of health resources in ourcountry.The nursing intervention measures guided by concept of ERAS can improve analgesic effect,reduce anxiety of patients in perioperative period,increase patient comfort.The nursing intervention measures guided by concept of ERAS can improve nursing quality,provide possibility and basis for the formulation of clinical nursing path and nursing guide. |
PDF Full Text Request