Application of enhanced recovery after surgery in perioperative nursing of patients with choledochojejunostomy (加速康复外科理念在胆肠吻合术患者围手术期护理中的应用研究)

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。)