基于加速康复外科理念的护理干预对脑胶质瘤患者术后康复及预后的影响

目的　探讨基于加速康复外科（ERAS）理念的护理干预对脑胶质瘤患者术后康复及预后的影响。方法　选择2020年5月至2021年8月于南阳市第二人民医院接受外科手术治疗的脑胶质瘤患者82例进行前瞻性研究。按随机数字表法分为两组，各41例。对照组男18例，女23例，年龄（50.93±4.89）岁；观察组男19例，女22例，年龄（51.24±5.37）岁。对照组实施常规护理，观察组实施基于ERAS理念的护理，干预至患者出院。比较两组患者术后康复情况、健康状况、日常生活能力及并发症发生情况。统计学方法采用t检验、χ²检验。结果　观察组患者术后首次排便时间、首次下床时间、拔尿管时间、疼痛持续时间及住院时间均短于对照组［（2.36±0.65）d比（3.44±1.03）d、（1.32±0.55）d比（2.09±0.73）d、（7.47±1.05）h比（24.88±2.19）h、（1.97±0.30）d比（3.09±1.14）d、（5.65±0.73）d比（7.76±1.22）d］，差异均有统计学意义（t=5.678、5.394、45.900、6.084、9.503，均P<0.001）。术前，两组Karnofsky功能状态（KPS）评分、改良Barthel指数（MBI）评分比较，差异均无统计学意义（均P>0.05）；术后1周，两组KPS、MBI评分均高于术前，差异均有统计学意义（均P<0.001）；术后1周，观察组KPS评分、MBI评分均高于对照组［（62.31±7.56）分比（53.82±6.45）分、（71.65±10.39）分比（60.78±7.20）分］，差异均有统计学意义（t=5.470、5.506，均P<0.001）。观察组并发症总发生率低于对照组［4.88%（2/41）比19.51%（8/41）］，差异有统计学意义（χ²=4.100，P=0.043）。结论　基于ERAS理念的护理干预利于减少脑胶质瘤患者术后并发症的发生，促进患者康复，改善预后。

Effect of nursing intervention based on the ERAS concept on postoperative rehabilitation and prognosis in patients with glioma

Objective　To explore the impact of nursing intervention based on the concept of enhanced recovery after surgery (ERAS) on postoperative rehabilitation and prognosis in patients with glioma. Methods　A prospective study was conducted on 82 patients with glioma who received surgical treatment in Nanyang Second People's Hospital from May 2020 to August 2021. According to the random number table method, they were divided into two groups with 41 cases in each group. In the control group, there were 18 males and 23 females, with an age of (50.93±4.89) years old; there were 19 males and 22 females in the observation group, with an age of (51.24±5.37) years old. The control group was given routine nursing care, and the observation group was given nursing care based on the concept of ERAS, intervening until the patients were discharged from the hospital. The postoperative rehabilitation, health status, daily living ability, and complications were compared between the two groups. t test and χ² test were used for statistical analysis. Results　The postoperative first defecation time, first getting out of bed time, urinary catheter removal time, pain duration, and hospital stay in the observation group were shorter than those in the control group (2.36±0.65) d vs. (3.44±1.03) d, (1.32±0.55) d vs. (2.09±0.73) d, (7.47±1.05) h vs. (24.88±2.19) h, (1.97±0.30) d vs (3.09±1.14) d, (5.65±0.73) d vs (7.76±1.22) d], with statistically significant differences (t=5.678, 5.394, 45.900, 6.084, and 9.503; all P<0.001). Before surgery, there were no statistically significant differences in the Karnofsky Performance Status (KPS) score and modified Barthel index (MBI) score between the two groups (both P>0.05); 1 week after surgery, the KPS and MBI scores of the two groups were higher than those before surgery, with statistically significant differences (all P<0.001); 1 week after surgery, the KPS and MBI scores of the observation group were higher than those of the control group (62.31±7.56) vs. (53.82±6.45), (71.65±10.39) vs. (60.78±7.20)], with statistically significant differences (t=5.470 and 5.506; both P<0.001). The total incidence of complications in the observation group was lower than that in the control group 4.88% (2/41) vs. 19.51% (8/41)], with a statistically significant difference (χ²=4.100, P=0.043). Conclusion　Nursing intervention based on the ERAS concept is helpful to reduce the occurrence of postoperative complications of glioma, promote the patients' rehabilitation, and improve their prognosis.