多学科合作-快速康复理念在退行性腰椎管狭窄症患者围手术期中的应用效果

目的探讨多学科合作-快速康复理念(MDT-FTS)在退行性腰椎管狭窄症(LSS)患者围手术期中的应用效果。方法选取河南省某医院2016年4月-2019年4月收治的退行性LSS患者132例为研究对象,采用随机数字表法将患者分为实验组(n=66)、对照组(n=66)。对照组患者采用常规护理,实验组患者在对照组护理基础上,附加MDT-FTS护理,2组患者均护理至顺利出院。比较2组患者术后首次进食时间、首次排便时间及护理后2组患者纽卡斯尔护理服务满意度量表(NSNS)评分;比较护理前后2组患者Oswestry功能障碍指数问卷表(ODI)及巴氏量表(Barthel)评分。结果对照组患者术后首次进食时间为(6.77±0.91)h,首次排便时间为(26.33±2.70)h,实验组患者首次进食时间为(4.56±0.82)h,首次排便时间为(16.13±2.30)h。实验组患者的术后首次进食时间、排便时间均短于对照组,差异有统计学意义(P<0.05)。护理前,2组患者ODI、Barthel评分比较,差异均无统计学意义(P>0.05)。护理后,2组患者ODI评分低于护理前,且实验组明显低于对照组,差异均有统计学意义(P<0.05);Barthel评分高于护理前,且实验组明显高于对照组,差异均有统计学意义(P<0.05)。实验组患者对护理的总满意度为93.94%,高于对照组81.82%,差异有统计学意义(P<0.05)。结论MDT-FTS应用于退行性LSS患者围手术期,有助于加快患者的康复进程,提高患者的术后生活自理能力及护理满意度。

Application of multidisciplinary team-fast track surgery in the perioperative nursing of patients with degenerative lumbar spinal stenosis

Objective To explore the effect of adopting the approach of multidisciplinary team-fast track surgery(MDT-FTS)in perioperative nursing of patients with degenerative lumbar spinal stenosis(LSS).Methods A total of 132 patients with degenerative LSS admitted to a hospital in Henan were enrolled as the research subjects from April 2016 to April 2019.The subjects were divided into an experimental group(n=66)and a control group(n=66)using a random number table.Patients in the control group were given routine nursing care,while patients in the experimental group received MDT-FTS nursing in addition.The time to first meal,time to first bowel movement and Newcastle Satisfaction with Nursing Scale(NSNS)scores after treatment were compared between the two groups;the Oswestry Dysfunction Index(ODI)and Barthel Index(Barthel)scores before and after nursing were compared between the two groups.Results The time to first meal in the control group was(6.77±0.91)h,and the time to first bowel movement was(26.33±2.70)h;the time to first meal in the experimental group was(4.56±0.82)h,and the time to first bowel movement was(16.13±2.30)h.The time to first meal and time to first bowel movement in the experimental group were shorter than those in the control group,and the difference was statistically significant(P<0.05).Before nursing,there was no significant difference in ODI and Barthel scores between the two groups(P>0.05).After nursing,the ODI score of the two groups of patients was lower than those before nursing,and that of the experimental group was significantly lower than the control group(P<0.05);Barthel score of the two groups was higher than before nursing,and that of the experimental group was significantly higher than the control group(P<0.05).The total satisfaction with nursing of patients in the experimental group was 93.94%,higher than 81.82%of the control group,and the difference was statistically significant(P<0.05).Conclusion Application of the concept of multidisciplinary team-fast track surgery in the perioperative nursing of patients with degenerative lumbar spinal stenosis speeds up the rehabilitation process of patients and improves the patients′postoperative self-care ability and satisfaction with nursing.