Evaluation Of The Effect Of Enhanced Recoveryafter Surgery On Perioperative Nursing Of Patients Undergoing Thorascoscopic Radical Resection Of Lung Cancer

ObjectiveTo construct the perioperative nursing care of Enhanced Recovery After Surgery(ERAS)for patients after thoracoscope resection of lung cancer,and apply it to clinical practice,to explore the role of ERAS nursing in perioperative period of patients after thoracoscope resection of lung cancer and evaluate the feasibility.MethodsThrough literature review,the primary ERAS nursing for patients after thoracoscope resection of lung cancer intervention program was preliminarily constructed.The feasibility of the intervention program was demonstrated by the experts on-site consultation method,and the ERAS nursing intervention program was established.Using the convenient sampling method,one sick area was selected as the intervention group in three thoracic areas of one tertiary hospital in Shanghai,and one area was the control group.From September 2016 to July 2017,100 patients weretreated with lung cancer surgery in each area.Collect and compare the two groups of patients with general information,preoperative fasting time,preoperative feelings of hunger or thirst,early postoperative ambulation time,postoperative exhaust time,postoperative nausea and vomiting,postoperative pain,postoperative extubation time,postoperative anxiety,nursing service satisfaction,postoperative complications,postoperative hospitalisation time and the total cost of hospitalization.Results1.The feasibility of the ERAS nursing care for patients after thoracoscope resection of lung cancer was demonstrated by the experts on-site consultation,and the ERAS nursing intervention program was established according to the experts opinions.The program was consisted of three parts,the first part was the preoperative nursing,including preoperative health education,airway management and fasting strategy;the second part was the preoperative nursing,including the optimization of anesthesia and insulation;the third part was the postoperative care,including pain management,airway management,early postoperative eating,early ambulation after surgery,chest management and Venous Thromboembolism(VTE)prevention.2.(1)Compared with the control group,the intervention group patients preoperative fasting time was significantly shortened,the feelings of preoperative hunger and thirst was significantly lower(P<0.05);(2)Compared with the control group.The anxiety questionnaire scores of patients in the intervention group was significantly lower than the control group,the difference was statistically significant(P<0.05);(3)Compared with the control group,the pain scores of the intervention group after 6h,12 h,24h and 48 h was significantly reduced,the incidence of postoperative nausea and vomiting was significantly lower,the difference was statistically significant(P<0.05);(4)Compared with the control group,the intervention group of patients with postoperative ambulation time was significantly shorter,postoperative exhaust time was significantly shorter,postoperative extubation time was significantly shorter,the difference was statistically significant(P<0.05);the rate of postoperative complications in the intervention group was lower than the control group,but the difference was not statistically significant(P<0.05);postoperative hospitalisation time in the intervention group was significantly shorter than the control group,the difference was statistically significant(P<0.05);the intervention group hospitalization costs slightly higher than the control group,but the difference was not statistically significant(P<0.05);patients in the intervention group the nursing service satisfaction was significantly higher than the control group,the difference was statistically significant(P<0.05).Conclusions1.The perioperative management of ERAS in patients after thoracoscope resection of lung cancer constructed in this research is feasible in nursing practice.2.ERAS nursing program can improve perioperative anxiety patients,shorten the preoperative fasting time,reduce preoperative feelings of hunger and thirst.3.ERAS nursing program can promote postoperative recovery,speed up early postoperative ambulation,reduce postoperative pain experience and promote intestinal function recovery,shorten the postoperative extubation time,shorten the postoperative hospitalisation time and speed up the hospital bed rotation rate,improve nursing satisfaction.