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Objective To investigate the effect of care bundles based on the concept of enhanced recovery after surgery in perioperative nursing of patients undergoing laparoscopic cholecystectomy. Methods A total of 260 cases of laparoscopic cholecystectomy were randomly divided into observation group (n=130, received routine nursing care) and control group (n=130, received care bundles based on the concept of enhanced recovery). Postoperative recovery condition, incidence of complications and postoperative pain were compared between the two groups. Results At 2, 6 and 24 h after surgery, the Visual Analogue Scale of pain in the observation group were lower than those in the control group, with a significant difference(P＜0. 05). The time to first postoperative exhaustion, time to off-bed activities and hospital stays in the observation group were shorter than those in the control group (P＜0. 05). The incidence of vomiting, incision infection, and bile leakage in the control group was significantly higher than that in the observation group, with a significant difference (P＜0. 05). Conclusion The application of care bundles based on the concept of enhanced recovery after surgery are conducive to the postoperative recovery of patients undergoing laparoscopic cholecystectomy, as well as the improvement of postoperative quality of life. (目的 探讨基于加速康复外科理念的集束化干预措施在腹腔镜胆囊切除患者围术期护理中的应用效果。方法 选取2021年1月—2023年1月某三甲肝胆专科医院收治的260例行腹腔镜胆囊切除术的患者为研究对象, 随机分为两组: 对照组(n=130)围手术期间给予常规护理; 观察组(n=130)实施基于加速康复外科理念的集束化干预措施。比较两组术后恢复情况、并发症发生率以及术后疼痛情况。结果 术后2 h、6 h、24 h观察组患者疼痛视觉模拟(VAS)评分低于对照组, 差异有统计学意义(P＜0. 05)。与对照组相比, 观察组患者术后排气时间、下床时间和住院天数均缩短, 差异有统计学意义(P＜0. 05)。对照组呕吐、切口感染与胆漏发生率高于观察组, 差异有统计学意义(P＜0. 05)。结论 基于加速康复外科理念的集束化干预措更有利于患者术后康复, 提高术后生活质量 。)

Objective To investigate the knowledge, attitude and practice compliance of patients with chronic rhinosinusitis on enhanced recovery after endoscopic sinus surgery (ERAS), and to analyze the influencing factors. Methods A total of 147 patients with chronic rhinosinusitis who underwent endoscopic sinus surgery in the otorhinolaryngology head and neck surgery ward of a tertiary general hospital in Chongqing from February 2023 to June 2023 were selected as the research objects. A self-made questionnaire was used to investigate the general situation of patients and the knowledge, attitude and practice of perioperative ERAS nursing. Results A total of 156 questionnaires were collected, of which 147 were valid, with an effective recovery rate of 94.23%. Among 147 patients, the nursing knowledge score rate of nasal endoscopic surgery accelerated rehabilitation surgery was 46. 36%, attitude 75.60%, behavior 71.25%, and the overall score rate of knowledge, faith and practice was 62.11%, which was in the lower middle level. The results of multi-factor analysis showed that the disease course and previous nasal surgery history were the main influencing factors for the nursing knowledge level of patients with chronic rhino-sinusitis undergoing ERAS, gender and disease course were the main influencing factors for the nursing attitude of patients with endoscopic ERAS, and gender was the main influencing factors for the nursing compliance of patients with endoscopic ERAS. Conclusion Patients undergoing endoscopic surgery for chronic rhino-sinusitis have poor cognition and behavioral compliance with the nursing concept of ERAS. Clinical publicity and education of patients should be strengthened to improve the surgical effect. [ABSTRACT FROM AUTHOR]

Exploring the perioperative application effect of a process based communication model combined with the concept of accelerated recovery after surgery (ERAS) in children with congenital spi- nal deformities (CS), and summarizing clinical experience. Methods This study is a prospective study. A to- tal of 68 pediatric patients with CS who underwent surgical treatment in our hospital from February 2022 to Feb- ruary 2023 were selected as the study subjects. They were divided into a study group (n=34) and a control group (n=34) based on management mode. The control group adopted a simple ERAS perioperative manage- ment model, while the research group adopted a procedural communication model combined with ERAS philoso- phy for perioperative intervention. Compared the time of first postoperative discharge, wound healing time, aver- age hospital stay, Chinese version of the screening chart (screen for child anxiety related emotional disorders, SCARED) Score, Chinese version of children Depression Disorder scale (depression self-rating scale for chil- dren, DSRSC) differences in scores, treatment adherence scores, number of ERAS measures completed, compli- cation rate, and pain scores. Results Among all patients, 27 were male and 41 female, mean age (8.31 ± 3.79) years, and there was no significant difference between the baseline data of the two groups (P>0.05). The postoperative time of first discharge and wound healing time in the study group were (32.76 ±5.57) h and (8.41±1.65) d, significantly earlier than the control group (62.94±7.81) h and (9.56±2.60) d (first discharge time t=18.345, P<0.001; wound healing time 12.173,P=0.033). The mean hospital day of stay in the study group was (11.12±2.14) d, significantly shorter than d (15.18±2.48) in the control group (17.221,P<0.001). Tthe two groups' admission SCARED score [Study group (20.65 ±2.01) s. Control group (20.18±2.17), 0.928, P=0.357] and DSRSC score (study group (12.59±2.12) rs, control group (12.68±2.07), 0.174,P=0.863] not significant (P greater than 0.05). However, the SCARED and DSRSC scores of the study group were (12.35 ±2.10) and (9.88±1.70), significant lower (18.59± 1.79) and (11.09±1.85) points than the control group, The differences were statistically significant (P was less than 0.05); [Study group (13.76 ±1.44) ts. control group (9.32 ± 1.84), 11. 102, P<0.001], number of items completed by ERAS measures [Study group (15.91 ±1.49) rs. Control group (13.35 ± 1.54),16.987,P<0.001],complication rate (5.88% of the study group rs. 23.53 of the control group, x = 4.221,P=0.040) and pain score [study group (2.91±0.87) zs. control group (3.76 ± 1.39),1 = 3.031,P=0.003] were all superior over the control group. Conclusions The application of a procedural communication model combined with ERAS concept in perioperative management of CS patients has a better effect, which can effectively improve the postoperative rehabilitation level and treatment compliance of patients, reduce their psychological stress level, and reduce the incidence of complications. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery (ERAS) refers to adopting a serial of evidence-based perio- perative optimizations for minimizing surgical traumatic stresses and complications. It is quite established in a- dults, but less so in children. Due to its particularity, pediatric cardiac surgery is characterized by high risk, high precision and complex operation so that there are complex surgical stresses. This review summarized the applica- tion status of ERAS during pediatric cardiac surgery and provided references for its in-depth applications. [ABSTRACT FROM AUTHOR]

Objective To investigate the feasibility of early removal of nasogastric tube after pancreaticoduodenectomy, and provide evidence for clinical practice based on the enhanced recovery after surgery and improve the quality of perioperative nursing. Methods A retrospective analysis on patients who underwent pancreaticoduodenectomy between April 2020 and January 2021 was conducted. Patients were divided into two groups: early removal group (≤48 h) and late removal group( >48 h). Univariate analysis and multiple logistic regression analysis were used to investigate the difference of perioperative rehabilitation between two groups. Results Of 257 patients included in the study, early removal of nasogastric tube was reported in 150(58. 37% patients. Univariate analysis showed that there was a significant difference in surgery duration (P=0. 024), nasogastric tube replacement(P=0. 002), complications (P=0. 002), length of hospital stay(P=0. 046)between two groups. Multiple logistic regression analysis showed that surgery duration(3～5 h) was the independent factor influencing the removal of nasogastric tube after pancreaticoduodenectomy(OR=0. 546, 95%CI: 0. 323-0. 921, P=0. 023). Conclusion Surgery duration was the independent factor influencing the removal of nasogastric tube after pancreaticoduodenectomy. Patients may benefit from early removal of nasogastric tube, and comprehensive evaluation should be carried out to ensure the safety of early removal of nasogastric tube. The establishment of a doctor-nurse integration team may contribute to the implementation of enhanced recovery after surgery-based comprehensive interventions and improvement of rehabilitation quality after surgery. (目的 对胰十二指肠切除手术后鼻胃管早期拔除可行性进行分析, 为临床医生遵循快速康复外科(ERAS)理念, 优化患者围手术期康复过程提供循证依据。方法 回顾性收集科室2020年4月—2021年1月接受胰十二指肠切除术治疗患者的临床资料。根据术后鼻胃管拔除时间分为早期拔除组(≤48 h)和晚期拔除组(>48 h), 采用单因素分析、Logistic回归多因素分析的方法, 分析两组患者围手术期康复情况的差异。结果 共有257例患者纳入本研究, 其中早期拔除鼻胃管150(58. 37%)例。单因素分析提示两组患者在手术时长(P=0. 024)、是否重置胃管(P=0. 002)、并发症(P=0. 002)、住院天数(P=0. 046)等方面差异有统计学意义。多因素分析提示两组患者手术时长(3～5 h)(OR=0. 546, 95%CI: 0. 323-0. 921, P=0. 023)差异有统计学意义。结论 手术时长是影响鼻胃管早期拔除直接因素; 胰十二指肠切除手术后早期拔除胃管可使患者获益; 在综合评估的基础上早期拔除鼻胃管是安全的; 医护一体化专业化团队有利于ERAS综合措施的贯彻执行开展, 帮助患者更好的理解配合, 实现加速康复目标。)

目的: 分析 ERAS 在老年 IFF 患者中的应用效果。方法: 选取2023年5月-2024年 5 月本院 74 例老年 IFF 患者 开展研究, 用随机数字表法平均分为对照组 37 例, 行常规护理, 观察组 37 例, 行 ERAS 护理, 比较两组护理效果。结 果: 观察组的 SF-36 和 Harris 评分均明显高于对照组, VAS 评分、输血率、并发症发生率、术中出血量、首次下地时 间、术后引流量和住院时间均明显低于对照组 (P < 0.05)。结论: 给予老年 IFF 患者 ERAS 护理能加快康复进程, 改 善髋关节功能, 缓解疼痛, 调节预后, 具有推广价值。 [ABSTRACT FROM AUTHOR]

Objective To explore the practice and significance of the new course of "Enhanced Recovery after Surgery (ERAS) and Perioperative Management" for graduate students under multidisciplinary cooperation. Methods The Department of Anesthesiology collaborated with the Department of Clinical Nutrition, Department of Geriatrics and six related surgical departments to develop a course of 30 credit hours on "ERAS and Perioperative Management" in Peking Union Medical College Hospital. Researchers analyzed the teaching effectiveness of the course by collecting survey questionnaires and evaluating scheme report of ERAS case. Results Researchers found that ten graduates joined this course and they believed that learning improved their understanding of ERAS related knowledge, such as preoperative nutrition and functional state optimization, intraoperative volume and temperature management, prevention of postoperative nausea and vomiting, and perioperative pain management. Students had high satisfaction with the course and believed that it would help improve their clinical literacy. Conclusions The new course of "ERAS and Perioperative Management" for graduates may support capacity building in terms of clinical logic and thinking about ERAS and promotion of skills for perioperative management. Our experience of graduates'training with "Enhanced Recovery after Surgery and Perioperative Management" course can be shared by other trainers of health institution of China. [ABSTRACT FROM AUTHOR]

Objective: To study the application effect of early rehabilitation training based on the concept of enhanced recovery after surgery (ERAS) combined with the first four types of Baduanjin in patients after modified radical mastectomy for breast cancer. Methods: 128 breast cancer patients who underwent modified radical mastectomy in the The First Affiliated Hospital of Hunan University of Chinese Medicine from September 2019 to May 2022 were selected. Patients were divided into control group (early rehabilitation training based on the ERAS concept, n=64) and study group (control group received the first four types of Baduanjin intervention on the basis of control group, n=64) according to the random number table method. The self-rating depression scale (SDS) score, health survey summary (SF-36), self-rating anxiety scale (SAS) score, Constant-Murley shoulder function score, pain visual analogue score (VAS) and shoulder joint activity were compared between two groups. Results: Compared with control group, the SDS and SAS scores in study group were lower after intervention (P＜0.05). Compared with control group, the emotional/physiological function, physical pain, social/physiological function, vitality, overall/mental health scores in study group were higher (P＜0.05). Compared with control group, the VAS score was lower and the Constant-Murley shoulder function score was higher in study group after intervention (P＜0.05). Compared with control group, anteflexion, extension, and abduction joint activity in study group was greater after intervention (P＜0.05). Conclusion: The application of early rehabilitation training based on ERAS combined with the first four types of Baduanjin in patients after modified radical mastectomy for breast cancer can improve the quality of life of patients, which may be relate to alleviating anxiety and depression, reducing postoperative pain and promoting the recovery of shoulder joint function. [ABSTRACT FROM AUTHOR]

Objective To determine risk factors of postoperative pulmonary complications within 1 month in patients undergoing thoracic surgery in Day Care Unit. Methods The total of 200 patients routinely scheduled for VATS under centralized management were enrolled in this study. On the postoperative day 1， lung ultrasound （LUS） was conducted by one physician in the ward. The patients received at least once Chest X⁃ray or CT in outpatient department within 30 days after discharge. The composite of out⁃of⁃hospital PPCs， and the value of LUSS in predicting the PPCs was appraised. Furthermore， we identified the perioperative risk factors associated with PPCs in VATS patients. Results Of 200 recruited VATS patients eligible in the Nanjing Drum Tower Hospital，188 participants received LUS examination and finally completed the 30 days follow⁃up. Of whom，68 patients developed the varied types of PPCs. Multivariable Logistic regression analysis indicated that comorbidity of immune system disease（P = 0.021）， lobar resection （P = 0.031） and the postoperative 24 hours LUSS （P = 0.002） were independent risk factors for PPCs within 30 days after VATS. Conclusion Comorbidity of immune system disease ，lobar resection and the postoperative 24 h LUSS were independent risk factors for PPCs within 30 days after VATS。 [ABSTRACT FROM AUTHOR]

In order to investigate the clinical effect of unidirectional barbed continuous suture and continuous edge stitching with absorbable thread in accelerated rehabilitation of total knee arthroplasty. A total of 106 patients who underwent total knee replacement surgery in Handan Central Hospital from March 2020 to June 2022 were selected and divided into control group (52 cases) and observation group (54 cases). In the control group, the incision was continuously hemmed and sutured with absorbable wire, and in the observation group, the incision was continuously sutured with one-way barbed wire. The differences in suture time, operation time, blood loss, postoperative hospital stay, knee function, knee range of motion (ROM) and complications were compared between the two groups. The results show that the suture time of observation group is shorter than that of control group (P < 0. 05), and the incidence of subcutaneous ecchymosis and needle puncture is lower than that of control group (P < 0. 05). There are no significant differences in operation time, mean blood loss, mean length of hospital stay, hospital for special surgery knee score(HSS), Rasmussen score, knee ROM, incidence of incision redness, incision infection and delayed incision healing between the two groups (P > 0. 05). It is concluded that Unidirectional barbed continuous suture can shorten the suture time, reduce the incidence of postoperative subcutaneous ecchymosis and needle puncture, and has certain advantages in accelerating the rehabilitation of total knee replacement incision suture. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

目的 探讨加速康复外科(ERAS)理念在腹腔镜下治疗小儿嵌顿性腹股沟斜疝围手术期护理 中的应用效果。方法 选取2016-2021年该院普外科收治入院的247例行腹腔镜治疗嵌顿性腹股沟斜疝的 患儿为研究对象,分为ERAS组(159例)和常规组(88例)。比较2组患儿胃肠功能恢复时间、住院时间、住院 费用、疼痛评分、家长及护士满意度等。结果 ERAS组患儿术后首次排便时间、首次进食时间、住院时间、住 院总费用、家长住院满意度均优于常规组,患儿不同时间疼痛程度、术后并发症发生率,护士工作强度均低于常 规组,护士工作满意度优于常规组,差异均有统计学意义(P <0.05)。 结论 在腹腔镜下治疗小儿嵌顿性腹股 沟斜疝围手术期护理中应用ERAS理念,可以促进患儿术后恢复,提高家属满意度,明显减少护理人员工作量。 [ABSTRACT FROM AUTHOR]

Objective To investigate the feasibility and safety of modified enhanced recovery after surgery (ERAS) in laparoscopic partial nephrectomy. Methods A retrospective analysis was conducted with the clinical data of renal tumor patients treated with laparoscopic partial nephrectomy in the Urology Department of Peking Union Medical College Hospital from May 2019 to June 2021. According to the peri-operative ERAS strategy, they were divided into modified ERAS group and conventional group. The postoperative recovery and complications of the two groups were compared. Results A total of 243 patients were enrolled, including 142 in the modified ERAS group and 101 in the conventional group. There was no significant difference between the two groups in baseline of indicators such as region, age, gender and tumor stage. The time records of first drinking water, the time of first exhaust, the first off-bed movement, catheter removal and drainage tube removal, the post-operative hospital stay and the total expense of hospitalization in the improved ERAS group were significantly superior to those in the conventional group (all P＜0.05). Conclusions The application of improved ERAS during the peri-operative period of laparoscopic partial nephrectomy may accelerate post-operative recovery. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical efficacy of enhanced recovery after surgery (ERAS) plus erector spinae plane block (ESPB) for post-untethering analgesia in children. Methods: The relevant clinical data were retrospectively reviewed for 79 children with tethered cord syndrome (TCS) from January 2020 to November 2022.A total of 40 cases were in conventional administration group from January 2020 to March 2021 and 39 cases in ERAS+ ESPB group from April 2021 to November 2022.Pain degrees, function outcomes and complication rates of two groups were compared within 3 days post operation. Results: Significant inter-group differences existed in pain scores at 24/48/72 h post-operation ( F=24.261, P<0.001).Pain scores of conventional and ERAS+ ESPB groups were statistically significant ( F=176.080, P<0.001).Interaction between time factor and group was statistically significant ( F=9.566, P<0.001).Further analysis of separate effects of postoperative analgesic management at different monitoring timepoints and groups revealed no statistically significant difference in pain scores between 24 h and 48 h post-operation in conventional group ( P=0.180) and pain scores declined significantly at 72 h versus 24/48 h post-operation ( P<0.001).Pain scores at Day 3 post-operation decreased obviously with the elapsing of time in ERAS+ ESPB group ( P<0.001).Pain scores were significantly lower in ERAS+ ESPB group than those in conventional group at 24/48/72 h post-operation ( P<0.001).Regarding postoperative function outcomes, length of hospital stay dropped in ERAS+ ESPB group compared with conventional group [(9.23±1.13) vs.(13.85±2.9) day, t=4.683, P=0.022], frequency of postoperative analgesic pump compression declined greatly in ERAS+ ESPB group versus conventional group[(5.67±1.94) vs.(9.18±2.65), t=3.818, P=0.031].Start time of postoperative functional exercise of lower extremity was significantly shorter in ERAS+ ESPB group than that in conventional group [(4.62±0.66) vs.(7.75±0.54) day, t=8.689, P=0.006].No inter-group difference existed in catheter removal time [(6.66±0.84) vs.(6.51±0.72) day, t=1.665, P=0.249].The incidence of postoperative complications was significantly lower in ERAS+ ESPB group than that in conventional group [ n=3(7.7%) vs. n=10(25%), χ 2=4.302, P=0.038]. Conclusions: Implementing ERAS plus ESPB can effectively control early postoperative pain, accelerate function recovery, reduce complications, shorten hospital stay and improve quality-of-life in TCS children. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinical effect and prognostic impact of dexmedetomidine based analgesic sedation mode under enhanced recovery after surgery (ERAS) concept on postoperative patients with traumatic cerebral hemorrhage. Methods Clinical data related to patients with post-traumatic cerebral hemorrhage from 2008 to 2019 in the MIMIC-IV database were retrospectively collected for the study, and patients who were combined with dexmedetomidine analgesic sedation were recorded as the dexamethasone group and non-users as the non-dexamethasone group, with 28-day all-cause death as the primary outcome, and patients in both groups were matched using propensity score matching, balanced between-group covariates, and prognostic factors were analyzed using multifactorial logistic regression, and overall survival was compared using Kaplan-Meier curves and Log-rank tests. Results A total of 526 patients were included in the study, 163 in the dexamethasone group and 363 in the non-dexamethasone group. Compared with the dexamethasone group, the clinical characteristics were older, more male, more hypertensive patients, and higher GCS scores in the non-dexamethasone group; in terms of laboratory tests, the non-dexamethasone group had a lower heart rate at ICU admission and higher prothrombin time (PT), alanine transaminase (ALT), and glutathione transaminase (AST) were higher; there were also significant differences in comorbidities. Using propensity score matching, 138 pairs were successfully matched between the two groups, and the covariates between groups were balanced after matching. Before matching, multifactorial logistic regression showed that the use of dexmedetomidine was a protective factor after surgery in patients with TBI (P＜0.05,95% CI= 0. 191-0. 599), with a lower OR of 0. 662 compared with the non-dexmed group. Kaplan-Meier survival curve showed a higher 28-day morbidity and mortality rate in the non-dexamethasone group, Log-rank test resultχ~2=13. 56,P＜ 0. 05; after matching, multifactorial logistic regression showed a 0. 613 lower OR in the dexamethasone group compared to the non-dexamethasone group (P＜ 0. 05,95%CI= 0. 201-0. 745), Kaplan-Meier survival curves showed a higher 28-day morbidity and mortality rate in the non-dexamethasone group, Log-rank test resultχ~2= 8. 24,P＜ 0. 05.Conclusion Dexmedetomidine based analgesic sedation reduces the risk of death at 28 days postoperatively in patients with traumatic cerebral hemorrhage. [ABSTRACT FROM AUTHOR]

Objective·To investigate the status of early mobilization and influencing factors of the patients undergoing laparoscopic radical resection of colorectal cancer (CRC). Methods·The convenience sampling method was used to select patients undergoing laparoscopic radical resection of CRC in the Department of Colorectal Surgery and Department of General Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from January to December, 2022. The patients′ general information, disease-, surgery- and postoperation-related information, and the situation of postoperative early mobilization were collected by bedside interview and electronic medical record system at 24 h, 48 h and 72 h after surgery. The influencing factors were analyzed by univariate analyses and binary Logistic regression. Results·A total of 277 patients were included. Within 24 h after surgery, 47 patients got out of bed with the early mobilization rate of 16.97%. The walking distance of these patients was 55.46 (18.28, 145.60) m within 24 h after surgery, with a minimum of 2.60 m and a maximum of 803.68 m. The average scores of Brown rating of mobility within 24 h, >24－48 h, and >48－72 h after surgery were 2 (0, 4) points, 8 (0, 10) points, and 8 (8, 10) points, which respectively belonged to the low level, moderate level, and moderate level. There were statistical differences in age, preoperative hemoglobin level, anesthesia duration, and the number of indwelling catheters between the early mobilization group and the non-early mobilization group (all P<0.05). Initial exhaust time, initial defecation time and postoperative length of stay of the early mobilization group were significantly shorter than those of the non-early mobilization group (all P<0.05). There were no postoperative complications in the early mobilization group, while the postoperative complications occurred in 11 patients in the non-early mobilization group with the incidence of complications of 4.78%. Binary Logistic regression analysis showed that age≥70 years old, low preoperative hemoglobin level and long anesthesia duration had significant influence on postoperative early mobilization (all P<0.05). Conclusion·Early mobilization of patients after laparoscopic radical resection of CRC can significantly accelerate postoperative rehabilitation, but the current status of early mobilization needs to be improved. Age, preoperative hemoglobin level and anesthesia duration are influencing factors of early mobilization. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Sichuan University (Medical Science Edition) is the property of Editorial Board of Journal of Sichuan University (Medical Sciences) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The enhanced recovery after surgery (ERAS)has been widely applied in the treatment of rehabilitation of patient with total knee arthroplasty (TKA). The ERAS has been proved to be effective in relieving pain, shortening the length of hospital stay, reducing economic and social healthcare costs. By reviewing literatures, this paper summarized the application of appropriate technology of Traditional Chinese and western medicine based on the concept of ERAS in TKA, and provided reference for improvement of perioperative nursing of TKA. (近年来, 加速康复外科(ERAS)理念在骨科全膝关节置换术(TKA)患者治疗和康复中得到了应用和普及, 基于ERAS的干预能够减轻患者痛苦, 缩短住院周期, 节约经济成本和社会医疗资源成本。本文通过文献搜索, 归纳总结基于ERAS理念的中西医结合护理干预在TKA围手术期中的应用, 旨在为提升TKA护理质量提供参考。)

This paper summarized the rehabilitation nursing management of a patient with severe traumatic brain injury complicated with multiple rupture of thoracic-abdominal organs based on the concept of enhanced recovery after surgery. Based on the enhanced recovery after surgery, a multidisciplinary team for rehabilitation management was set up. Comprehensive treatment and nursing interventions including postoperative management of intracranial pressure, management of traumatic liver injuries, exercise rehabilitation, postoperative thromboembolism prevention, enteral nutrition support and management of antiepileptic drug were carried out to prevent postoperative complications and improve the rehabilitation. (本文总结1例基于加速康复外科(ERAS)理念的重型颅脑创伤伴肝脾破裂、肋骨骨折、肺、肾挫裂伤危重症患者的康复护理经验。基于ERAS理念, 组建多学科康复管理团队, 制定全面的康复治疗方案, 包括术后颅内压管理、创伤性肝损伤康复、运动康复管理、术后血栓预防管理、术后肠内营养管理、术后抗癫痫等详细的康复方案, 有效预防相关并发症, 促进患者康复。)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the efficacy and safety of preoperative oral carbohydrates in patients with thyroid cancer.Methods A total of 134 patients who underwent thyroid cancer surgery in the hospital from January 2021 to March 2022 were selected and divided into the study group (70 cases) and the control group (64 cases) based on their admission time.The control group was treated with routine fasting and drinking, while the study group was treated with preoperative oral carbohydrate therapy on the basis of the control group.The postoperative recovery, perioperative blood indicators and incidence of complications were compared between the two groups.Results The first exhaust time, first bowel movement time, hospitalization time, and total hospitalization cost after surgery in the study group were better than those in the control group, with statistically significant differences (P＜0.05). There were no significant differences in the levels of fasting blood glucose, white blood cell count and C-reactive protein before surgery between the two groups (P＞0.05). The fasting blood glucose, white blood cell count, and C-reactive protein levels at 1,3 days after surgery in the study group were lower than those in the control group, with statistically significant differences (P＜0.05). The incidence of postoperative nausea and vomiting in the study group was lower than that in the control group, and the difference was statistically significant (P＜0.05). There were no statistically significant differences in the incidence of postoperative numbness of hands and feet, bleeding and suffocation, hoarseness, coughing due to drinking water, and chylous fistula between the two groups (P＞0.05). Conclusion Preoperative oral carbohydrates in thyroid cancer patients can reduce perioperative stress response, improve insulin resistance, reduce the incidence of postoperative nausea and vomiting, promote patients′ recovery, shorten hospitalization time, and save hospitalization costs. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the application effect of enhanced recovery after surgery in perioperative nursing of patients with choledochojejunostomy. Methods Totally 80 patients undergoing choledochojejunostomy were randomly divided into the control group and observation group, with 40 cases in each group. Patients in the control group received routing care during the treatement, and those in the observation group received perioperative nursing interventions based on the theory of enhanced recovery after surgery. Primary outcomes were first anal exhaust time, length of hospital stay, hospitalization costs and incidence of postoperative complications. Secondary outcomes were time to remove the gastric tube, time to remove the urinary catheter, time to food-taking, time to off-bed activity and volume of fluid infusion. Results The first anal exhaust time and length of hospital stay in the observation group were shorter than those in the control group (P＜0. 01). The hospitalization costs in the observation group was lower than that in the control group (P＜0. 01). The time to remove the gastric tube, time to remove the urinary catheter and time to off-bed activity in the observation group were shorter than those in the control group (P＜0. 01). The volume of fluid infusion in the observation group was less than that in the control group (P＜0. 01). The incidence rate of complications in the observation group was lower than that in the control group (P＜0. 05). Conclusion The enhanced recovery after surgery is effective and safe in perioperative nursing of patients with choledochojejunostomy, it has a positive effect on reducing the incidence of postoperative complications. (目的 探讨基于加速康复外科理念的护理干预在胆肠吻合术患者中的应用方法及效果。方法 选择2018年1月—2020年8月住院行胆肠吻合术的80例患者为研究对象, 按照随机分组方法将患者分为对照组和观察组, 各40例。对照组给予常规护理, 观察组实施基于加速康复外科理念的护理干预。主要指标: 首次肛门排气时间、住院时间、住院费用、并发症的发生率; 次要指标: 拔除胃管时间、尿管时间、进食时间、下床时间、输液量。结果 观察组首次肛门排气时间、住院时间均较对照组缩短, 差异有统计学意义(P＜0. 01), 观察组住院费用较对照组减少, 差异有统计学意义(P＜0. 01)。观察组拔除胃管时间、拔尿管时间、进食时间以及下床时间较对照组缩短, 差异有统计学意义(P＜0. 01), 观察组输液量也明显少于对照组, 差异有统计学意义(P＜0. 01)。观察组并发症发生率低于对照组, 差异有统计学意义(P＜0. 05)。结论 在胆肠吻合术患者围术期护理中的应用加速康复外科理念安全有效, 对降低术后并发症发生率具有积极意义。)

Objective Methods Totally 96 children with appendicitis requiring surgical treatment were divided into the two group according to the sequence of hospital admissions: 48 cases with admission date between Jan and Dec, 2020 were included as the control group, receiving routine management after surgery; 48 cases with admission date between Jan and Dec, 2021 were included as the observation group, receiving nursing management using specialist care quality indicators based on doctor-nurse-patient integration model. The primary outcomes included: ambulation distance within 24 hrs after surgery and rate of qualified early ambulation; Time of first exhaust and defecation, postoperative first out-of-bed activity time, first time to food-taking and incidence of symptoms of postoperative discomfort; satisfaction of children’s parents with communication and information support, respect, emotional support and high-quality nursing care. Results ambulation distance within 24 hrs after surgery in the observation group was longer than that in the control group (P＜0. 01). The rate of qualified early ambulation in the observation group (27. 08%) was higher than that in the control group (97. 92% vs. 27. 08%, P＜0. 01). The time of first exhaust and defecation, postoperative first out-of-bed activity time, first time to food-taking in the observation group was shorter than that in the control group(P＜0. 01, respectively). Parents of children in the observation group were more satisfied with communication and information support, respect, emotional support and high-quality nursing care compared with those in the control group(P＜0. 01). Conclusion Application of specialist care quality indicators based on doctor-nurse-patient integration model is potentially effective to improve the children’s compliance with early ambulation, promote the development of standard nursing procedure, improve the parents’ satisfaction and quality of specialist care. The To investigate the effect of specialist care quality indicators based on doctor-nurse-patient integration model in improving compliance with early ambulation in children with appendicitis. (目的 在加速康复外科理念下, 探讨医护患一体化专科护理质量指标管理提高阑尾炎患儿术后早期下床活动中的效果。方法 选取医院小儿外科2020年1月—2021年12月收治的96例阑尾炎的患儿为研究对象。将2020年1月—12月收治的48例患儿作为对照组, 运用常规护理管理落实术后早期下床活动; 将2021年1月—12月收治的48例患儿作为观察组, 运用医护患一体化专科护理质量指标管理落实术后早期下床活动。比较两组患儿术后24 h下床活动距离及达标情况; 术后首次排气排便时间、首次下床活动时间、首次进食时间、术后不适症状(恶心呕吐及腹胀)发生率; 患儿家属在沟通和信息支持、尊重支持、情感支持以及优质护理照护支持四个维度方面的满意度。结果 观察组患儿术后24 h下床活动距离较对照组增加, 差异有统计学意义(P＜0. 01)。观察组术后24 h下床活动达标率(97. 92%)高于对照组(27. 08%), 差异有统计学意义(P＜0. 01)。观察组术后首次下床活动时间、首次排气时间、首次排便时间、首次进食时间均早于对照组, 差异有统计学意义(P＜0. 01), 观察组术后恶心呕吐腹胀发生率低于对照组, 差异有统计学意义(P＜0. 05)。观察组患儿家属在沟通和信息支持、尊重支持、情感支持以及优质护理照护支持四个维度满意度评分高于对照组, 差异有统计学意义(P＜0. 01)。结论 医护患一体化的专科质量指标的实施, 提高了阑尾炎患儿术后早期下床活动的依从性, 促进了标准护理工作的开展, 提高了患儿家属的满意度, 提升了专科护理服务质量水平。)

This paper summarizes the perioperative nursing experience of a centenarian patient with intertrochanteric fracture of femur undergoing Proximal Femoral Bionic Nail(PFBN) internal fixation. The mind mapping mission mode was adopted, and patient was given comfortable nursing intervention. Based on Traditional Chinese Medicine therapy, tapping therapy and massage were carried out to ensure patient comfort. Moreover, standardized thrombotic prevention measures, enhanced recovery after surgery, personalized functional exercise path, and progressive rehabilitation training were carried out to reduce the risk of perioperative deep vein thrombosis free and improve the early functional recovery. (本文总结1例百岁老人股骨粗隆间骨折行新型仿生髓内钉内固定的围手术期护理经验。采用思维导图宣教模式, 给予患者舒适护理干预, 开展中医养生护理, 采用敲打、按摩的方式提升患者舒适度; 制定规范的血栓预防措施, 运用加速康复外科理念、个性化功能锻炼路径、递进式康复训练, 降低患者围术期深静脉血栓发生风险, 促进早期功能恢复。)

Objective To investigate the value of quality control circle (QCC)activities in reducing the incidence of adverse factors for rapid recovery after surgical treatment for laryngeal cancer. Methods A convenient sample of 35 patients with surgical treatment for laryngeal cancer were selected as the control group, another 28 patients were recruited as the observation group. The quality control circle(QCC) activity group was set up by the medical and nursing integration. Based on the clinical practice, the adverse factors affecting the rapid recovery of laryngeal cancer patients were found, analyzed and improved through the QCC activities, and the effect analysis was carried out. Results Quality evaluation had been taken 225 times in the control group and 224 times in the observation group , respectively. The incidence of adverse factors affecting the rapid recovery of patients with laryngeal cancer decreased from 46. 67% (105/225)to 11. 61%(26/224), with a target achievement ratio of 126. 56%. Shorter length of hospital stay and lower cost of hospitalization were found in the observation group than those in the control group (P＜0. 05). Conclusion The QCC activity an effective management tool for reducing the incidence of adverse factors in rapid recovery of laryngeal cancer patients, promoting medical and nursing cooperation, optimizing clinical pathways, improving the quality of medical care, shortening the length of hospitalization and reducing medical costs. (目的 探究品管圈活动降低喉癌患者快速康复不良因素发生率的效果。方法 采用便利抽样法选取2020年12月21日—2021年3月21日医院收治的喉癌住院患者35例为对照组, 2021年6月1日—2021年8月31日收治的喉癌患者28例为观察组。医护一体成立品管圈活动小组, 从临床实际出发, 通过品管圈方法查找、分析并改进影响喉癌患者快速康复的不良因素, 并进行效果分析。结果 对照组和观察组总检频次分别为225例次和224例次。影响喉癌患者快速康复不良因素发生率改善前为46. 67%(105/225), 改善后为11. 61%(26/224), 目标达成率126. 56%。观察组住院时间较对照组缩短, 住院费用较对照组降低, 差异有统计学意义(P＜0. 05)。结论 品管圈活动有效降低了喉癌患者快速康复不良因素发生率, 促进医护合作, 优化临床路径, 提高医疗护理质量, 缩短住院时间, 降低医疗费用。)

Objective To explore the effect of enhanced recovery after surgery (ERAS) combined with pelvic floor magnetoelectric stimulation therapy to optimize the perioperative management on postoperative recovery of elderly women with pelvic organ prolapse. Methods A total of 110 elderly female patients treated in this hospital from June 2020 to May 2021 were selected as the study subjects and divided into the study group and control group by adopting the random number table method, 55 cases in each group. The study group used ERAS combined with pelvic floor magnetoelectric stimulation therapy. The control group adopted the routine perioperative management scheme.The operation-related indexes and the incidence rates of postoperative complications were compared between the two groups, and the scores of Quality of Recovery-40 questionnaire（QoR-40）,Pelvic Floor Distress Inventory-short form 20（PFDI-20）,Pelvic Floor Impact Questionnaire-7（PFIQ-7） before and after operation were compared between the two groups. Results There was no statistically significant difference in the general condition, operation time, intraoperative blood loss volume, time of anesthesia recovery room and postoperative fever between the two groups（P＞0.05）.The first time to get out of bed, first exhausting time, first eating time, first defecating time and hospitalization time in the study group were superior to those in the control group; the incidence rates of postoperative nausea and vomiting, abdominal distension, urinary retention and venous thrombosis in the study group were significantly lower than those in the control group, and the differences were statistically significant（P＜0.05）.The PFDI-20 and PFIQ-7 scores in postopertive 3 months in the study group were significantly lower than those in the control group, the QoR-40 score at postoperative 24,48 h in the study group was significantly higher than that in the control group, and the difference between the two groups was statistically significant（P＜0.05）.Conclusion The application of ERAS combined with pelvic floor magnetoelectric stimulation therapy can promote the perioperative recovery of elderly women with pelvic organ prolapse, reduce the incidence rate of postoperative complications, relieve the patients′ discomfort and improve the quality of life after operation. Objective To explore the effect of enhanced recovery after surgery (ERAS) combined with pelvic floor magnetoelectric stimulation therapy to optimize the perioperative management on postoperative recovery of elderly women with pelvic organ prolapse. Methods A total of 110 elderly female patients treated in this hospital from June 2020 to May 2021 were selected as the study subjects and divided into the study group and control group by adopting the random number table method, 55 cases in each group. The study group used ERAS combined with pelvic floor magnetoelectric stimulation therapy. The control group adopted the routine perioperative management scheme.The operation-related indexes and the incidence rates of postoperative complications were compared between the two groups, and the scores of Quality of Recovery-40 questionnaire（QoR-40）,Pelvic Floor Distress Inventory-short form 20（PFDI-20）,Pelvic Floor Impact Questionnaire-7（PFIQ-7） before and after operation were compared between the two groups. Results There was no statistically significant difference in the general condition, operation time, intraoperative blood loss volume, time of anesthesia recovery room and postoperative fever between the two groups（P＞0.05）.The first time to get out of bed, first exhausting time, first eating time, first defecating time and hospitalization time in the study group were superior to those in the control group; the incidence rates of postoperative nausea and vomiting, abdominal distension, urinary retention and venous thrombosis in the study group were significantly lower than those in the control group, and the differences were statistically significant（P＜0.05）.The PFDI-20 and PFIQ-7 scores in postopertive 3 months in the study group were significantly lower than those in the control group, the QoR-40 score at postoperative 24,48 h in the study group was significantly higher than that in the control group, and the difference between the two groups was statistically significant（P＜0.05）.Conclusion The application of ERAS combined with pelvic floor magnetoelectric stimulation therapy can promote the perioperative recovery of elderly women with pelvic organ prolapse, reduce the incidence rate of postoperative complications, relieve the patients′ discomfort and improve the quality of life after operation. [ABSTRACT FROM AUTHOR]

Kidney transplantation is the most effective treatment for end-stage renal disease in clinical practice. Compared with patients receiving dialysis, kidney transplant recipients may achieve higher survival rate and quality of life, and better clinical outcomes. However, kidney transplant recipients constantly develop physiological and psychological disorders, such as frailty, decreased cardiopulmonary function and cognitive dysfunction, etc. In recent years, with the application of the concept of enhanced recovery after surgery (ERAS), rehabilitation therapy plays a pivotal role in optimizing preoperative baseline function, mitigating perioperative physiological and psychological stress and reducing the incidence of postoperative complications. In this article, the application of ERAS in kidney transplantation was reviewed, and research progress on pre-rehabilitation before kidney transplantation and acute-stage rehabilitation after kidney transplantation was summarized, aiming to provide reference for perioperative rehabilitation of kidney transplantation, enhance the quality of life of kidney transplant recipients and accelerate the development of kidney transplantation techniques. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To evaluate the application value of perioperative interventional strategy guided by enhanced recovery after surgery (ERAS) in elderly recipients undergoing liver transplantation. Methods Clinical data of 405 liver transplant recipients were retrospectively analyzed. According to age, all recipients were divided into the elderly (≥60 years, n=122) and non-elderly groups (<60 years, n=283). All patients received perioperative interventions under the guidance of ERAS. Intraoperative and postoperative indexes, incidence of postoperative complications and discharge were analyzed between two groups. Results There were no significant differences in the duration of anesthesia, operation time, anhepatic phase, hemorrhage volume, blood transfusion volume, lactic acid level before abdominal closure, ventilatorassisted time, the length of intensive care unit (ICU) stay, Caprini score, CHIPPS score, time of gastric tube, urinary tube and drainage tube removal, time to first drinking, time to first physical activity and time to first flatus between two groups (all P>0.05). In the elderly group, the time to first feeding was later than that in the non-elderly group (P<0.05). There were no significant differences in the incidence of fever, ascites, pulmonary infection, delayed gastric emptying, hemorrhage and inactive venous thrombosis between two groups (all P>0.05). No significant differences were observed in the levels of aspartate aminotransferase, total bilirubin, direct bilirubin, serum creatinine before discharge and total length of hospital stay between two groups (all P>0.05). The alanine aminotransferase level in elderly recipients was lower than that in nonelderly counterparts, and the difference was statistically significant (P<0.05). No unplanned reoperation was performed within postoperative 30 d in two groups. There was no significant difference in the re-hospitalization rate within 30 d after discharge (P>0.05). Conclusions ERAS-guided interventional strategy contributes to perioperative recovery of elderly recipients undergoing liver transplantation, and yields equivalent postoperative recovery between elderly and non-elderly recipients. Objective To evaluate the application value of perioperative interventional strategy guided by enhanced recovery after surgery (ERAS) in elderly recipients undergoing liver transplantation. Methods Clinical data of 405 liver transplant recipients were retrospectively analyzed. According to age, all recipients were divided into the elderly (≥60 years, n=122) and non-elderly groups (<60 years, n=283). All patients received perioperative interventions under the guidance of ERAS. Intraoperative and postoperative indexes, incidence of postoperative complications and discharge were analyzed between two groups. Results There were no significant differences in the duration of anesthesia, operation time, anhepatic phase, hemorrhage volume, blood transfusion volume, lactic acid level before abdominal closure, ventilatorassisted time, the length of intensive care unit (ICU) stay, Caprini score, CHIPPS score, time of gastric tube, urinary tube and drainage tube removal, time to first drinking, time to first physical activity and time to first flatus between two groups (all P>0.05). In the elderly group, the time to first feeding was later than that in the non-elderly group (P<0.05). There were no significant differences in the incidence of fever, ascites, pulmonary infection, delayed gastric emptying, hemorrhage and inactive venous thrombosis between two groups (all P>0.05). No significant differences were observed in the levels of aspartate aminotransferase, total bilirubin, direct bilirubin, serum creatinine before discharge and total length of hospital stay between two groups (all P>0.05). The alanine aminotransferase level in elderly recipients was lower than that in nonelderly counterparts, and the difference was statistically significant (P<0.05). No unplanned reoperation was performed within postoperative 30 d in two groups. There was no significant difference in the re-hospitalization rate within 30 d after discharge (P>0.05). Conclusions ERAS-guided interventional strategy contributes to perioperative recovery of elderly recipients undergoing liver transplantation, and yields equivalent postoperative recovery between elderly and non-elderly recipients. [ABSTRACT FROM AUTHOR]

近年来，随着社会经济的发展和人们生活方式的改变，女性健康受到了越来越多的关注。妇科病不仅严 重影响着女性的生活质量，还可能导致诸多并发症，严重影响着生育和生命安全。因此，怎样有效预防和治疗妇科 病，提高女性生活质量已成为医疗行业和社会各界关注的焦点。 [ABSTRACT FROM AUTHOR]

目的：探究加速康复外科在胸外科围手术期护理中的效果。方法：选取于2021年1月至2023年1月本院收 治的68例胸外科手术患者，随机分为观察组（加速康复外科护理）、对照组（常规护理）各34人。结果：相比对照 组，观察组护理满意度高、并发症低，且不良情绪、生活质量改善明显（P < 0.05）。结论：加速康复外科在胸外科 围手术期护理中应用可以获得更为理想的护理效果。 [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the clinical value and safety of enhanced recovery after surgery ( ERAS) plus colonoscopy for colorectal polypi in children. Methods Clinical data were retrospectively reviewed for 200 children undergoing endoscopic resection of colorectal polypi. They were randomized into two groups of ERAS plus colonoscopic polypectomy ( n = 100 ) and conventional perioperative management plus colonoscopic polypectomy ( n = 100) . Perioperative treatment, clinical symptoms, surgical parameters, biochemical indices and postoperative adverse reactions were recorded. Results Operative duration of ERAS and control groups was [ ( 27. 77 ± 8. 76) vs. ( 33. 88 ± 6. 58) min], postoperative defecation time [ ( 1. 50 ± 0. 50) vs. ( 3. 50 ± 1. 00) days] and hospitalization duration [ ( 3. 00 ± 1. 00) vs. ( 6. 00 ± 1. 00) days]. In ERAS children, blood glucose post-operation was significantly higher than that pre-operation[ 5. 75 (5. 15, 6. 08) vs. 5. 10 ( 4. 80, 5. 90), z = - 3. 807, P < 0. 001], blood insulin spiked significantly post-operation[ 16. 30 ( 15. 70, 16. 90) vs. 7. 55(6. 30,9. 05), z = - 8. 682,P < 0. 001], insulin resistance index post-operation was significantly higher than that pre-operation[ 4. 07 (3. 77, 4. 34) vs. 1. 72( 1. 46,2. 02), z = - 8. 682, P < 0. 001], blood glucose post-operation in control group was significantly higher than that in ERAS group [ 9. 60 ( 8. 90, 10. 80) vs. 5. 75(5.15, 6. 08), U =21. 000, P <0. 001], blood insulin was significantly higher in control group than that in ERAS group[22. 80(21. 73, 23. 68) vs. 16. 30( 15. 70, 16. 90), P <0. 001] and insulin resistance index was significantly higher in control group than that in ERAS group[9. 77(8. 89,10. 77) vs. 4. 07(3. 77, 4. 34), P < 0. 001]. Two group are no aspiration during operation and abdominal pain was ( 6 vs. 21), diarrhea ( 4 vs. 5), vomiting ( 5 vs. 24) and dizziness ( 23 vs. 5) . VAS was significantly higher in control group than that in ERAS group[ (6. 00 ± 1. 00) vs. (3.50 ± 1. 00), X² =38. 000,P <0.001]. Conclusion After colonoscopy for colorectal polypi, ERAS can accelerate the rehabilitation and lower postoperative complications in children. It is both safe and feasible in the management of endoscopic smgery. [ABSTRACT FROM AUTHOR]

Objective To analyze the research status and frontier hotspots of accelerated rehabilitation nursing in obstetrics and gynecology in China.Methods The data were obtained from CNKI, WanFang, VIP and SinoMed databases,and the statistical source literature was screened.EndNote X9 was used for literature management of the accelerated recovery nursing research in obstetrics and gynecology,and Excel was used for quantitative analysis of years,regions,institutions,journals and citations.The authors and keywords were used to analyze the partnership relationship with VOSviewer 1.6.17. Results A total of 1132 related literatures were detected,including 134 statistical sources.In the past five years, the number of articles published in the database had grown rapidly, with a maximum of 370 articles in 2020, mostly in East China,while the highest in Jiangsu Province was 144 articles.The number of articles published in statistical source journals had grown steadily,with a maximum of 26 articles in 2019, and a maximum of 5 articles in Beijing. Jiangxi Maternal and Child Health Hospital (18 articles) and Southwest Hospital of Army Military Medical University (5 articles) were the first publishing institutions of the databases and statistical sources, respectively. The Electronic Journal of Practical Clinical Nursing (47 articles) and Nursing Research (10 articles) were the first publication journals of the databases and statistical sources, respectively. Most of the literature types were clinical trials (databases accounted for 75.6%, statistical sources accounted for 78.4%), and the most surgical types were laparoscopy (databases accounted for 46.2%,statistical sources accounted for 40.3%). There was less crosscooperation between domestic authors, and the main research keywords were enhanced recovery surgery,nursing, and perioperative period/perioperative period. Conclusion The research on accelerated rehabilitation nursing in obstetrics and gynecology in my country shows a rapid upward trend in general, with laparoscopy as the hotspot, but the proportion of high-level journals is relatively small.It is necessary to further improve the research quality and formulate practice guidelines based on evidence. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the efficacy and safety of enhanced recovery after surgery (ERAS) in the perioperative period of pancreaticoduodenectomy (PD). Methods Chinese and English databases were searched for controlled clinical trials on the application of ERAS in PD published from 2000 to 2021. Screening, quality assessment, and data extraction were performed for the articles, and RevMan5. 3 software was used for meta - analysis. This study was registered on PROSPERO with a registration number of CRD42021287931. Results A total of 22 controlled clinical trials were included, with 353 1 patients in total. The results showed that the implementation of ERAS in the perioperative period of PD reduced the incidence rates of total complications (odds ratio [OR] = 0. 63, 95% confidence interval [ CI] : 0. 48 ~ 0. 83, P = 0. 001), abdominal infection (OR = 0. 65, 95 % CI: 0. 47 ~ 0. 88, P = 0. 005), pulmonary complications ( OR = 0. 57, 95 % CI : 0. 42 ~ 0. 78, P = 0. 000 5), pancreatic leakage ( OR = 0. 80, 95 % CI : 0. 67 ~ 0. 97, P = 0. 02 ), and delayed gastric emptying (OR = 0. 58, 95 % CI: 0. 48 ~ 0. 71, P < 0. 001 ) and effectively shortened the length of postoperative hospital stay ( mean difference = - 2. 76, 95 % CI: - 3. 36 to - 2. 16, P < 0. 001 ). However, there were no significant differences between the two groups in mortality rate, incision infection, postoperative bleeding rate, reoperation, and rehospitalization ( all P > 0. 05 ). Conclusion ERAS has good efficacy and safety in the perioperative period of PD and can significantly reduce the incidence rates of postoperative complications and shorten the length of postoperative hospital stay. Therefore, it holds promise for clinical application. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery (ERAS) has been popular during adult surgery. Recently people have shifted their attention to children. Children’s special disease spectrum and tolerance to anesthesia and surgery are different from those of adults. Thus it has challenged the focus of ERAS approach. The incidence of adverse reactions such as pain, bloating, psychological or eating disorders remains high during perioperative period of surgery for pediatric pectus excavatum (PE).Thus postoperative recovery is poor. Also PE children tend to be older and closer to adults in clinical management. Whether it can learn from the experience of adult surgery in ERAS and promote the accelerated rehabilitation of pediatric PE is a hot topic in recent years. This review summarized the concrete steps of promoting accelerated rehabilitation during perioperative period of pediatric PE in terms of analgesia, psychological counseling and postoperative rehabilitation. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery(ERAS) has been a hot research topic of modern surgery, and the core of ERAS is based on a high level evidence-based medicine, aiming to reduce the influence of surgical trauma and stress on patients, reduce the risk of postoperative complications, shorten the length of hospital stay and reduce hospitalization expenses. Perioperative nutrition, especially in enteral nutrition intake is particularly important for the prognosis of patients. This paper summarized the clinical research progress of enteral nutrition, especially oral nutritional supplement, in fast-track surgery for colorectal cancer and to provide reference and basis for its safety and implementation strategy. (术后加速康复是现代外科的研究热点, 其核心理念是基于高水平的循证医学证据, 减少患者的手术创伤和应激, 从而减少术后并发症, 缩短住院时间, 减少住院费用, 而围术期营养特别是肠内营养的摄入对患者的预后具有特别重要的意义。本文总结了目前关于结直肠癌加速康复外科肠内营养实施的临床研究进展, 为其安全性和实施策略提供参考和依据。)

Objective To investigate the status of readiness for hospital discharge(RHD)of patients with liver cancer under the concept of Enhanced Recovery After Surgery (ERAS), analyze its influencing factors, and provide the basis for regulating the discharge guidance. Methods Totally 128 patients with liver cancer were selected as the research object, and patients were investigated by using the general data questionnaire, the Readiness for Hospital Discharge Scale(RHDS) and the Quality of Discharge Teaching Scale(QDTS). Results The total score of RHDS was 146. 82±28. 69, and 75. 00%(96/128) of the patients were prepared for discharge. The results of univariate analysis suggested that age, place of residence, occupation, operation mode, per capita income of the family and the quality of discharge teaching were influencing factors of discharge preparation. The results of multivariate analysis suggested that age, residence, occupation and quality of discharge teaching were the independent factors affecting discharge readiness. Conclusion Under the under the concept of ERAS, the level of RHD for patients with liver cancer needs to be further improved, and medical staff should adopt various forms to strengthen the discharge preparation service, improve the quality of discharge guidance for specific target population, and focus on the elderly discharged patients. (目的 调查加速康复外科(ERAS)模式下肝癌患者的出院准备度(RHD)现状, 并分析其影响因素, 为规范患者出院指导提供依据。方法 采用一般资料调查表、出院准备度量表(RHDS)、出院指导质量表(QDTS)对128例肝癌患者进行调查, 并对结果进行分析。结果 ERAS模式下肝癌患者的出院准备度总分是(146. 82±28. 69)分, 75. 00%(96/128)的患者做好出院准备。单因素分析显示, 年龄、居住地、职业、手术方式、家庭人均月收入和出院指导质量是影响患者RHD的因素。多因素分析显示, 年龄、居住地、职业和出院指导质量是影响患者RHD的主要因素。结论 ERAS模式下, 肝癌患者RHD水平需进一步提高, 医护人员应采用多种形式加强出院准备服务, 针对特定目标人群提高出院指导质量, 重点关注老年出院患者。)

Objective To explore the effect of enhanced recovery after surgery (ERAS) in the perioperative nursing of elderly patients undergoing hip replacement. Methods Totally 58 elderly patients undergoing hip replacement were randomly divided into the observation group and the control group, with 29 cases in each group. The control group received routine care during the period of operation, while the observation group received perioperative nursing based on ERAS. The Activity of Daily Living (ADL), Harris Hip Score (HHS), Visual Analogue Pain Score (VAS) and were observed before intervention, 1 day, 1 week and 2 weeks after intervention, and the off-bed time was recorded. Results The ADL score and HSS score were significantly increased in both two groups at 2 weeks after intervention(P＜0. 05), and the VAS Score was decreased significantly at 2 weeks after intervention(P＜0. 05). Patients in the observation group achieved higher ADL score, higher HSS score and lower VAS score at 2 weeks after intervention compared with those in the control group (P＜0. 05) . T he off-bed time was (9. 45±2. 53) d in the observation group, which was shorter than (13. 83±3. 91) d in the control group (P＜0. 05). Conclusion The perioperative nursing based on ERAS is effective to reduce the postoperative pain of elderly patients undergoing hip replacement, and improve their activity of daily living. (目的 探讨加速康复外科(ERAS)理念在老年髋关节置换术围手术期护理中的应用效果。方法 58例行髋关节置换术的患者随机分为观察组和对照组, 各29例。对照组给予常规围手术期护理, 观察组基于ERAS理念开展围手术期护理。观察2组干预前、干预后1天、干预后1周以及干预后2周时的自理能力、髋关节功能以及疼痛程度。记录2组术后下床活动的时间。结论 干预后2周时, 2组日常生活活动能力量表(ADL)、髋关节功能评分(HSS)升高, 疼痛视觉模拟评分量表(VAS)评分降低, 与干预前比较, 差异有统计学意义(P＜0. 05); 干预后2周时观察组ADL、HSS评分高于对照组, VAS评分低于对照组, 差异有统计学意义(P＜0. 05)。观察组患者下床活动时间为术后(9. 45±2. 53) d, 短于对照组(13. 83±3. 91) d, 差异有统计学意义(P＜0. 05)。结论 基于ERAS理念开展老年髋关节置换术围手术期护理, 能有效缓解患者的疼痛, 提高日常生活自理的能力, 加快康复。)

Objective To explore the security and application effect of the concept of enhanced recovery after surgery (ERAS） in the perioperative period of patients with brain tumors. Methods A total of 72 patients with brain tumors requiring surgical treatment in this hospital from January 2017 to June 2019 were selected and randomly divided into the ERAS group (n=37） and the control group (n=35).The ERAS concept was used for perioperative treatment management in the ERAS group, while traditional perioperative treatment was used in the control group. The consciousness, pain level, and anxiety level of the patients in the two groups were assessed before and on the third day after surgery. After the patients were discharged, the postoperative hospitalization time, hospitalization cost, postoperative complication rate were statistically analyzed. Results The average hospitalization time, postoperative pain score, preoperative anxiety score, postoperative anxiety score and postoperative complications in the ERAS group were (13.86 ± 5.37) d, (4.00 ± 1.79) points, (50.83±12.61) points, (47.29±10.03) points,10.81% (4/37), respectively. The control group were (16.43 ± 5.22) d, (5.06 ± 1.49) points, (57.31 ± 12.50) points,(54.43 ± 10.41) points,22.86%（8/35) points, respectively. The differences were statistically significant between the two groups (P<0.05）.There were no significant differences in the hospitalization cost and preoperative pain score between the ERAS group and the control group (P>0.05). Conclusion The application of ERAS in the perioperative period of brain tumor patients can improve patient comfort, reduce the incidence of postoperative complications, shorten the average hospital time effectively and the clinical application is safe and effective. [ABSTRACT FROM AUTHOR]

Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO 2), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P<0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P<0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P>0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications. [ABSTRACT FROM AUTHOR]

目的 探讨术后康复指数 (PRI) 用于评估实施加速康复外科 (ERAS) 的腹腔镜结直肠癌手术患 者康复程度的可行性。方法 选取 2018 年 11 月至 2019 年 11月该院胃肠外科收治的择期行全身麻醉腹腔镜 结直肠癌手术患者 113 例,使用自行设计的 PRI 量化评分表于术前 1d、出院当天、术后 30d 进行评分,将术后 指标与术前指标进行对比,计算 PRI, 评估患者出院当天、术后 30d 的康复程度。结果 113 例患者出院时精 神、食欲、体重、体力状况、家庭理解与配合、社会活动影响 6 项量化指标 PRI 均小于100%; 疼痛、恶心/呕吐、腹 胀、腹泻、自身对癌症的认识、紧张/焦虑6项量化指标 PRI 均大于100%; 术后 30d 精神、食欲、体重、体力状 况、家庭理解与配合、疼痛、恶心/呕吐、腹胀、腹泻、自身对癌症的认识、紧张/焦虑 11 项量化指标 PRI均大于 100%; 仅社会活动影响1项量化指标 PRI<100%;出院时 12 项量化指标平均 PRI 为 97.2%; 术后 30d12 项 量化指标平均 PRI 为 105.6%。结论 PRI 可用于实施 ERAS 的腹腔镜结直肠癌手术患者的术后评价, 但需 进一步优化。 [ABSTRACT FROM AUTHOR]

To explore the mode and feasibility of ambulatory surgery (AS) for infantile hypertrophic pyloric stenosis (IHPS) during enhanced recovery after surgery (ERAS). Methods Retrospective analysis was performed for clinical data of 163 children hospitalized with infantile hypertrophic pyloric stenosis from January 2018 to December 2020. ERAS management model was adopted during perioperative period of IHPS since January 2018 and AS for IHPS since September 2019. Children admitted before September 2019 were designated as ERAS group and those after as ERAS + AS group. And children in ERAS group fulfilling the ambulatory surgery admission and discharge standards simultaneously at 15h post-operation were recorded as ERASI group and the remainders as ERAS2 group: Children in ERAS + AS group not completing ambulatory surgery mode were recorded as ERAS+AS 1 group while those not completing ambulatory surgery mode as ERAS + AS 2 group. The treatment-related clinical parameters and hospitalization expenses were recorded for exploring the feasibility of IHPS ambulatory surgery admission standards and models. Results All of them successfully completed transumbilical single-site laparoscopic pyloric myotomy. There was no conversion into laparotomy. Pyloric duct perforation was absent. Comparison of ERAS + AS 1 group and ERAS+ AS 2 group. operative age [(43.77 ± 15. 16) vs. (36.93±22.42) days), pre-admission course of disease [(15.59 ± 12,73) vs. (14.00 12.76) days) and frequency of vomiting within 1 week post-operation [(2.18±0.50) vs. (2.49 +0.59)). There was no significant inter-group difference (P>0.05); preoperative length of hospital stay [(11.64 +8.40) s. (52.07 31.40) hours),postoperative hospital stay [(18. 163.86) vs. (77.81 ±42.28) hours and hospitalization expense [(8 474. 16 +537.73) vs. (12 413,61 13 341.96) yuan]. The inter group differences were statistically significant (P <0.05); length of stay and hospitalization expense in day-to day surgery group were significantly lower than those in incomplete group. Comparing ERAS + AS 1 and ERAS I groups, frequency of vomiting within 1 week post-operation was [(2. 18±0.50) . (2.29 ± 0.60)]. There was no significant inter-group difference (P>0.05); preoperative length of hospitalization [(11.64 ±8.40) 15. (42.00 ± 16. 85) hours ], postoperative hospital stay [(18.16±3.86) s. (74.66 ± 14.02) hours and hospitalization expense [(8 474. 16 ±537.73) s. (12 891.76 ±3 181.31) yuan]. And inter-group difference was statistically significant (P<0.05). Conclusion Under the premise of mastering the admission standards of ambulatory surgery, AS for IHPS is both feasible and safe. It is worthy of further researches and explorations. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the effect of enhance recovery after surgery(ERAS) during the perioperative period for elderly patients with hip fracture. Methods The China National knowledge Infrastructure, China Biomedical Database, Wanfang database, VIP citation database and PubMed, Web of Science, EMBASE, Cochrane Library database were retrieved. Randomized controlled trials of ERAS in elderly hip fracture patients were collected from the establishment of the database to June 2019 at home and abroad. RevMan 5. 3 software was used for statistical analysis, and the effects and their 95% confidence interval(CI) were calculated. Results A total of 1336 samples from 16 literatures were included. The results of Meta-analysis showed that with the application of enhance recovery after surgery could reduce the visual pain simulation score of VAS［WMD=-0. 73, 95%CI(-0. 95, -0. 51), P＜0. 00001］, improve the Harris hip joint score［WMD=4. 28, 95%CI(2. 10, 6. 45), P=0. 0001］, advance the first time of getting out of bed［WMD=-1. 33, 95%CI(-1. 73, -0. 93), P＜0. 00001］, shorten the days of hospitalization［WMD=-3. 15, 95%CI(-3. 79, -2. 50), P

目的 了解加速康复外科模式 (ERAS)下肺癌术后患者出院准备度及出院指导质量的现状,分 析其相关性,为提高出院指导质量及患者出院准备度提供参考。方法 对 2020 年 8 月至 2021 年 2 月广州市某 三甲医院 ERAS 模式下的 127 例肺癌手术患者在出院日采用一般资料调查表、出院准备度量表、出院指导质量 量表进行调查。结果 患者出院准备度总分为 (78.70±4.80) 分,出院指导质量总分为 (90.45±4.21) 分,出院 准备度与出院指导质量呈正相关 (P<0.001)。结论 ERAS 模式下肺癌术后患者的出院准备度处于中等水 平,出院指导质量总体水平较好。医护人员应基于患者的知识诉求,根据实际情况采取多模式的健康教育方 式,提高出院指导质量,提高出院准备度。 [ABSTRACT FROM AUTHOR]

目的探讨基于加速康复外科(ERAS)理念的多方位围手术期麻醉管理在十二脂肠梗阻新生儿腹腔镜手 术中的应用效果。方法收集 42 例行腹腔镜手术的十二指肠梗阻新生儿,随机分为对照组 20 例和 ERAS 组 22例。 对照组采取围手术期一般麻醉管理方案,ERAS 组实施 ERAS 围手术期麻醉管理方案。比较两组手术情况,包括手术 时间､麻醉时间､术中舒芬太尼用量,术后拔气管导管时间,记录住院时间及住院费用;于术前1d及术后24h采集患 儿静脉血采用电化学发光法检测血清白细胞介素6(IL-6)水平,免疫比浊法检测血浆超敏C反应蛋白(hs-CRP)水 平,溴甲酚绿法检测血清白蛋白水平;观察术后48 h并发症(吻合口感染和梗阻,呼吸道感染,二次气管插管,发热,全 身或局部凹陷性水肿)的发生情况。结果两组手术时间､麻醉时间比较差异均无统计学意义(P均>0.05),ERAS 组术中舒芬太尼用量、术后拔气管导管时间､住院时间及住院费用均较对照组减少(P均<0.01)。术后 24 h ERAS 组 血清IL-6水平低于对照组(P<0.01),两组 hs-CRP 比较差异无统计学意义(P>0.05);两组术后白蛋白水平均低于 术前(P均<0.01),但组间比较无统计学差异(P>0.05)。两组术后并发症无统计学差异,但ERAS 组局部凹陷性水 肿发生率低于对照组(P<0.05) 结论 对十二脂肠梗阻新生儿腹腔镜手术运用 ERAS 理念进行多方位围手术期麻 醉管理,能够降低患儿的应激反应,减少住院时间和费用且不增加并发症的发生,安全可行。 [ABSTRACT FROM AUTHOR]