基于快速康复外科理念的护理模式对创伤性膈疝患者术后康复及疼痛程度的影响

目的探究基于快速康复外科（ERAS）理念的护理模式对创伤性膈疝患者术后康复及疼痛程度的影响。 方法选取2016年1月至2019年1月，琼海市人民医院重症医学科就诊的60例创伤性膈疝患者。按照随机数字表法分为常规组和试验组，每组30例。2组均行胸腔镜手术治疗，常规组予以常规护理干预，试验组予以基于ERAS理念的护理模式干预。比较2组的围手术期手术各项指标，护理前、护理后2 、4 、8 d及护理结束后的视觉模拟评分法（VAS），对比护理前与护理结束后生活质量评分及术后并发症发生情况。采用SPSS 18.0统计学软件进行数据处理。 结果试验组拔除胸腔引流管时间均短于常规组，差异有统计学意义（P<0.05）。与护理前比，护理2 d至护理结束后2组VAS评分均逐渐降低，且试验组护理后4 、8 d及护理结束后VAS评分均显著低于常规组，差异有统计学意义（P<0.05）。护理结束后2组生活质量各维度评分（躯体功能、心理功能、社会功能及物质状态功能）均显著高于护理前，且试验组高于常规组，差异有统计学意义（P<0.05）。试验组术后并发症发生率为3.33%，显著低于常规组的26.67%，差异有统计学意义（P<0.05）。 结论基于ERAS理念的护理模式可改善创伤性膈疝患者围手术期指标，有效减轻术后疼痛程度、降低并发症发生率，促进创伤性膈疝患者术后康复，提高其生活质量。

Influence of nursing mode based on enhanced recovery after surgery concept on postoperative rehabilitation and pain degree of traumatic diaphragmatic hernia patients

ObjectiveTo explore the effect of nursing mode based on enhanced recovery after surgery (ERAS) concept on postoperative rehabilitation and pain degree of traumatic diaphragmatic hernia patients. Methods60 patients with traumatic diaphragmatic hernia who visited the intensive medicine department of Qionghai people's hospital between January 2016 and January 2019 were selected and randomly divided into the routine group (n=30) and the experimental group (n=30). Both groups received thoracoscopic surgery, the routine group received routine nursing intervention, the experimental group received nursing mode intervention based on ERAS concept, and both groups received nursing till discharge. The perioperative indexes, VAS scores before nursing, 2 d, 4 d, 8 d after nursing and after nursing, quality of life scores before and after nursing and postoperative complications of the two groups were compared. ResultsThe time of thoracic drainage tube removal, and the amount of intraoperative hemorrhage in experimental group was lower than that in the routine group (P<0.05). Compared with before nursing, the VAS scores in the two groups decreased gradually from 2 d to the end of nursing, and the VAS scores in the experimental group were significantly lower than those in the routine group at 4 d, 8 d and the end of nursing (P<0.05). After nursing, the scores of all dimensions of quality of life (physical function, psychological function, social function and material state function) in the two groups were significantly higher than before nursing, and the experimental group was higher than the routine group (P<0.05). The incidence of postoperative complications in the experimental group was 3.33%, significantly lower than 26.67% in the routine group (P<0.05). ConclusionNursing mode based on ERAS concept can improve perioperative indicators of traumatic diaphragmatic hernia patients, effectively reduce postoperative pain, reduce the incidence of complications, promote postoperative rehabilitation and improve quality of life.