Clinical Application And Effectiveness Of Enhanced Recovery After Surgery(ERAS) In The Perioperative Nursing Of Prostate Cancer

ObjectivesThis thesis aims to apply the Enhanced Recovery after Surgery(ERAS)idea to perioperative nursing of radical prostate cancer and to investigate the clinical application effect of ERAS nursing model on the patients of perioperative period of radical prostate cancer by the analogical experiments.MethodsThe 85 prostate cancer patients selected from a first class hospital in Wuhan from June,2016 to January,2018 were used as the subject of study.The selected 41 prostate cancer patients from June,2016 to June,2017 was referred to be the control group using the traditional nursing,and the selected 44 prostate cancer patients from July,2017 to January,2018 was referred to be the testing group using ERAS nursing.The operations of the two groups of patients were implemented by the same medical group.All information of the patients including the general information,length of stay(LOS),hospitalization expenses,drug cost,incidence of complications,numbered pain rating scale(NRS),first exhaust time,ability of daily life(ADL)scale and patient satisfaction scale of responsibility nurses was acquired by the retrospective cases of patients and the section statistical document.All data for the investigation were analyzed and treated by software SPSS 20.0.The differences of patients between the traditional group and ERAS group were compared with respect to the incidence of complications after surgery,the first anal exhaust time after surgery,the length of stay after surgery,the hospitalization expenses,the drug cost,the numbered pain rating scale for 24 h,48 h,72 h after surgery,ADL scale and the patient satisfaction scale of responsibility nurses.Results(1)The two groups of patients are proportionate and comparable with respectto the age distribution,the degree of education,the marital status,themonthly household income and the medical payment method.There are noobvious difference with P> 0.05 in the two groups of patients with respectto the Body Mass Index,the prostate specific antigen,the Gleason scaleand the clinical stages.(2)The first anal exhaust average time after surgery of the two groups ofpatients is 21.3 h for ERAS and 34.h for the traditional group,respectively.Their difference has statistical significance with P< 0.05.(3)The difference in the total incidence of complications after surgery for thetwo groups of patients has statistical significance with P< 0.05 while thatin the individual incidence of complications after surgery for the twogroups of patients has not statistical significance with P> 0.05.(4)The comparison of the numbered pain rating scale(NRS)after surgery forthe two groups of patients shows that the NRS of ERAS is low substantiallythan that of the traditional group for 24 h,48 h,72 h after surgery.Theirdifference has statistical significance with P< 0.05.(5)The comparison of the ADL scale for the two groups of patients shows thatthe score of ERAS group for the ADL scale on the second day after surgeryare higher obviously than that of the traditional group,their difference hasstatistical significance with P< 0.05.However,the difference for the ADLscale on the fourth day after surgery has no statistical significance althoughthe score of the traditional group is higher than that of ERAS group.(6)The average stay time after surgery for ERAS group is 10.04 days whilethat for the traditional group is 12.73 days.The time for ERAS group isshort obviously than that for the traditional group and the difference hasstatistical significance with P< 0.05.(7)The average hospitalization expense of ERAS group is $ 92.7 thousandwith the average drug cost of $ 8.2 thousand while that of the traditionalgroup is $ 100.1 thousand with the average drug cost of $ 10.1 thousand.Obviously,both the average hospitalization expense and the average drugcost of ERAS are low than those of the traditional group,and the differencehas statistical significance with P< 0.05.(8)The score of the satisfaction of responsibility nurses for the two groups ofpatients is 48.3±0.9 for ERAS group and 47.1±1.2 for the traditional group,respectively,showing the higher score for ERAS group than that fortraditional group.This difference has statistical significance with P < 0.05.Conclusions(1)The ERAS is applied successfully in the perioperative nursing of radicalprostate cancer in this thesis.The results indicate that it can not onlyreduce the length of stay,decrease the hospitalization expenses,depress theincidence of complications after surgery and relieve the pain after surgery,but also improve the patient satisfaction and the nursing service quantity,which provides the solid basis for the clinical generalization of ERAS.(2)The ERAS nursing with the feasibility and science to some extent accordswith the requirement of evidence – based medicine and it can be able to beapplied in the total perioperative nursing of radical prostate cancer.As aresult,the ERAS could be used as guidance and reference of theadministration for the perioperative nursing of the clinical urinary surgery.