Application of Nursing Health Education Pathways Under ERAS Concept in Perioperative Period of Laparoscopic Liver Lobotomy
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摘要:
目的 在ERAS理念下根据肝癌疾病特点及围手术期的护理需求，构建腹腔镜肝叶切除围手术期护理健康教育路径并探讨其应用效果。 方法 选取2020年1月至2020年12月期间160例行腹腔镜肝叶切除术患者，随机分为对照组和实验组各80例。对照组患者围手术期采用传统的护理健康教育方法，而实验组患者采用护理健康教育路径。比较2组患者院前检查及术前准备时间、术后自我疼痛评估、下床活动时间、住院时间，患者满意度进行比较。 结果 除实验组与对照组患者在院前检查时间外，差异无统计学意义（P > 0.05），术前准备时间、术后自我疼痛评估，下床活动时间，患者满意度等都明显优于对照组，差异有统计学意义（P < 0.05）。 结论 基于ERAS理念下将护理健康教育路径运用于腹腔镜肝叶切除围手术期，可有效缩短住院时间，节省住院费用，减轻患者痛苦等方面取得良好效果。 -
关键词:
- ERAS理念 /
- 护理健康教育路径 /
- 腹腔镜肝叶切除围手术期
Abstract:Objective Under the concept of ERAS, according to the characteristics of liver cancer disease and perioperative nursing needs, this paper aims to establish the nursing health education during perioperative period of laparoscopic lobotomy and explore its application effect. Methods A total of 160 patients who underwent laparoscopic hepatectomy from January 2020 to December 2020 were randomly divided into control group （n = 80） and experimental group （n = 80）. Control group received traditional nursing and health education during perioperative period, while experimental group received nursing and health education pathways. The time of pre-hospital examination and preoperative preparation, postoperative self-pain assessment, time of activity out of bed, length of hospital stay and patient satisfaction degree were compared between the two groups. Results There was no significant difference in prehospital examination time between the experimental group and the control group （P > 0.05）. Preoperative preparation time, postoperative self-pain assessment, time of getting out of bed and patient satisfaction in the experimental group were significantly better than those in the control group （P < 0.05）. Conclusion Based on the concept of ERAS, the application of nursing health education pathways in the perioperative period of laparoscopic hepatectomy can effectively shorten the length of hospital stay, lower hospitalization costs and reduce the pain. -
表 1 2组院前检查时间、术前准备时间、住院时间比较[（
$\bar x \pm s$ ）d ]Table 1. Comparison of pre-hospital examination time，preoperative preparation time and hospital stay between the two groups [（
$\bar x \pm s$ ）d]组别 n 院前检查时间 术前准备时间 住院时间 实验组 80 1.475 ± 0.635 1.625 ± 0.643 7.66 ± 0.83 对照组 80 1.612 ± 0.584 1.938 ± 0.643 9.03 ± 0.643 t −1.835 −3.472 −9.787 P 0.07 0.001 0.000 
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表 2 2组早期（术后24～48 h内）首次活动时间及活动距离比较（
$\bar x \pm s$ ）Table 2. Comparison of the first activity time and distance between the two groups in early stage （within 24 h-48 h after operation）（
$\bar x \pm s$ ）组别 n 首次活动时间（min） 活动距离（m） 实验组 80 30.486 ± 5.558 77.925 ± 12.430 对照组 80 23.637 ± 3.277 65.187 ± 14.362 t 10.247 7.022 P 0.000 0.000
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表 3 首次进食时间、肛门排气排便时间、腹腔引流管拔出时间比较[（
$\bar x \pm s$ ）h]Table 3. Comparison of time of first eating，time of anal exhaust and defecation，and time of drawing out abdominal drainage tube [（
$\bar x \pm s$ ）h]组别 n 首次进食时间 肛门排气排便时间 腹腔引流管拔出时间 实验组 80 9.663 ± 1.090 21.263 ± 2.048 22.325 ± 1.954 对照组 80 16.075 ± 1.847 24.393 ± 1.393 24.950 ± 2.261 t −27.430 −10.846 −7.952 P 0.000 0.000 0.000
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表 4 术后疼痛自我评估和疼痛控制的满意率比较（
$\bar x \pm s$ ）Table 4. Comparison of satisfaction rate of postoperative pain self-assessment and pain control （
$\bar x \pm s$ ）组别 n 术后疼痛评分（24 h） 满意率（%） 静息时 活动时 实验组 80 0.788 ± 0.610 1.425 ± 0.742 98.938 ± 0.932 对照组 80 1.500 ± 0.746 1.850 ± 0.929 83.900 ± 3.644 t −6.481 −3.171 36.497 P 0.000 0.002 0.000
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