收稿日期: 2018-12-26
网络出版日期: 2019-05-06
Application of enhanced recovery after surgery in patients during the perioperative period of pituitary tumor resection by transsphenoidal approach
目的 探讨快速康复外科在经鼻蝶入路垂体瘤切除患者围手术期护理中的应用效果。 方法 按照入院先后顺序将择期手术的经鼻蝶入路垂体瘤切除患者分为两组,2014年4月—2016年11月入住的105例患者为对照组,2016年12月—2018年8月入住的105例患者为试验组。对照组围手术期实施常规护理,试验组通过在围术期采用一系列有效的优化护理措施,减轻患者心理和生理的创伤应激反应,干预后比较两组患者术后首次下床活动时间、住院时间、住院总费用、焦虑情况、术后48 h疼痛例数及术后并发症的差异。结果 试验组患者术后首次下床活动时间早于对照组,住院时间、住院总费用少于对照组,焦虑评分低于对照组,试验组患者术后48 h疼痛发生例数及并发症发生例数均少于对照组,差异均具有统计学意义（P＜0.05）。结论 应用快速康复外科理念对经鼻蝶入路垂体瘤切除患者实施围手术期护理是安全有效的,可有效减轻患者术后48 h疼痛及焦虑程度,促使患者早日下床活动,减少住院时间、住院总费用及术后并发症的发生,促进患者早日康复。
叶琳 , 底瑞青 , 赵玉林 , 张文静 , 岳高杰 . 快速康复外科理念在经鼻蝶入路垂体瘤切除患者护理中的应用[J]. 中华护理教育, 2019 , 16(4) : 301 -305 . DOI: 10.3761/j.issn.1672-9234.2019.04.016
Objective To explore the effects of enhanced recovery after surgery（ERAS） in patients during the perioperative period of pituitary tumor resection by transsphenoidal approach.Methods A total of 103 patients who were admitted from April 2014 to November 2016 were assigned to the control group. Another 105 patients admitted from December 2016 to August 2018 were assigned to the experimental group. Patients in the control group received routine care during perioperative period,while patients in the experimental group received ERAS. The outcomes compared between the two groups included the first time that patients are out of bed,length of stay in hospital,cost,anxiety,pain 48 hours after operation,and complications.Results The first time that patients were out of bed for activity in experimental group was earlier than that of the control group. The length of study in hospital and cost in the experimental group were less than that of the control group. The anxiety level in the experimental group was lower than that of the control group. The number of pain cases and complications in the experimental group were less than that of control group. All difference was statistically significant（P＜0.05）.Conclusion It is safe and effective to apply ERAS in patients undergoing pituitary adenoma resection by transsphenoidal approach. It can effectively alleviate the pain and anxiety level of the patients 48 hours after operation,make patients get out of bed early,reduce length of stay in hospital,total cost and the occurrence of postoperative complications,and promote the early recovery of the patients.
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