Application Of Medical And Nursing Integrated Enhanced Recovery After Surgery(EARS) Model In Perioperative Period Of Thoracolumbar Burst Fracture

Objective: Based on evidence-based medicine,this study constructed a perioperative accelerated rehabilitation program for patients with thoracolumbar burst fracture,and evaluated the effect of the perioperative accelerated rehabilitation program for patients with thoracolumbar burst fracture.Methods: The English keywords were thoracolumbar burst fracture/burst fracture of the lumbar spine,enhanced recovery after surgery/ERAS,fast track surgery/FTS,and the Chinese keywords were "thoracolumbar burst fracture/burst fracture of the lumbar spine","thoracolumbar burst fracture/fast track surgery/FTS".CNKI,WanFang database,PubMed,BMJ Best were retrieved.Practice,Cochrane Library,and ERAS-related Guidelines for Perioperative Accelerated Rehabilitation.The level of evidence included in the literature is divided into high,medium,low and very low;the level of recommendation is divided into strong recommendation and general recommendation,forming the best evidence summary,linking the content of evidence with clinical practice,and finally constructing a perioperative accelerated rehabilitation program for patients with thoracolumbar burst fracture.106 patients with thoracolumbar burst fracture treated and operated on in the Second Affiliated Hospital of Inner Mongolia Medical University from January 2018 to December 2018 were randomly divided into control group and observation group(ERAS group).The control group was treated with traditional perioperative nursing scheme,while the experimental group was treated with perioperative nursing of accelerated rehabilitation.By comparing the early recovery(first eating time,anal exhaust time,first getting out of bed activity time,catheter retention time),JOA score,total incidence of complications and hospitalization time and cost,etc.between the two groups.Results: 1.The implementation of perioperative accelerated rehabilitation program for patients with thoracolumbar burst fracture accelerated the recovery process of patients after operation.The first time to eat,first time to exhaust anus,first time to get out of bed,the first time to exhaust anus,the first time to exhaust anus,the catheter indwelling time shortened,the difference was statistically significant(P < 0.05).2.The implementation of perioperative accelerated rehabilitation program for thoracolumbar burst fracture shortened the hospitalization time and reduced the hospitalization cost,with statistical significance(P < 0.01).3.The implementation of perioperative accelerated rehabilitation program for thoracolumbar burst fracture reduces the incidence of complications after thoracolumbar burst fracture surgery,with statistical significance(P < 0.05).4.The total JOA score in ERAS group was significantly higher than that in control group at 1 and 4 weeks after operation(P < 0.01).Conclusion: 1.Evidence-based medical and nursing integration scheme for accelerated rehabilitation of thoracolumbar burst fracture is safe and feasible,which is conducive to speeding up the rehabilitation process,reducing the incidence of complications after surgery,and reducing hospital stay and costs.2.In the implementation of perioperative rapid plan for thoracolumbar burst patients,medical treatment and nursing are two inseparable subjects,which need to communicate and cooperate with each other,timely evaluation and feedback.Medical integration is one of the important factors for the successful implementation of ERAS.