基于循证护理的ERCP术中护理配合流程优化对手术安全性的影响

The Influence of ERCP Intraoperative Nursing Coordination Process Optimization on Surgical Safety Based on Evidence-Based Nursing

摘要: 目的：本研究旨在评估基于循证护理的ERCP术中护理配合流程优化对手术安全性的影响，包括手术用时、黏膜损伤程度、疼痛管理效果及并发症发生率。方法：采用简单随机抽样方法，选取2023年4月至2024年10月期间行ERCP术的70名患者，随机分为观察组和对照组，每组35名。对照组接受常规护理，而观察组则在此基础上实施基于循证护理的优化护理配合流程。通过比较两组患者的手术用时、黏膜损伤情况(洛杉矶分级)、术后VAS评分及并发症发生率来评估护理配合流程优化的效果。结果：观察组手术用时(45.67 ± 8.56分钟)显著短于对照组(52.43 ± 9.12分钟)，P < 0.01。黏膜损伤情况显示，观察组A级和B级损伤患者比例高于对照组，C级和D级损伤比例低于对照组，P < 0.01。观察组VAS评分(3.56 ± 1.47)显著低于对照组(5.89 ± 1.63)，P < 0.01。两组患者术后均未发生严重并发症。结论：基于循证护理的ERCP术中护理配合流程优化能显著减少手术用时，降低黏膜损伤程度，有效管理术后疼痛，并保持手术安全性。这一优化流程对于提高ERCP手术的效率和安全性具有重要意义。

Abstract: Objective: The purpose of this study was to evaluate the effect of ERCP intraoperative nursing coordination process optimization on surgical safety, including the duration of surgery, the degree of mucosal injury, the effectiveness of pain management and the incidence of complications. Methods: A total of 70 patients who underwent ERCP from April 2023 to October 2024 were selected by simple random sampling and randomly divided into observation group and control group, with 35 patients in each group. The control group received routine nursing, while the observation group was given an optimized nursing coordination process based on evidence-based nursing. The effect of nursing coordination process optimization was evaluated by comparing the operation time, mucosal injury (Los Angeles scale), postoperative VAS score and complication rate of the two groups. Results: The operation time of observation group (45.67 ± 8.56 minutes) was significantly shorter than that of control group (52.43 ± 9.12 minutes), P < 0.01. The mucosal injuries showed that the proportion of patients with grade A and B injuries in the observation group was higher than that in the control group, and the proportion of patients with grade C and D injuries was lower than that in the control group, P < 0.01. VAS score of observation group (3.56 ± 1.47) was significantly lower than that of control group (5.89 ± 1.63), P < 0.01. No serious complications occurred in both groups. Conclusion: The optimization of ERCP intraoperative nursing coordination process based on evidence-based nursing can significantly reduce the operation time, reduce the degree of mucosal injury, effectively manage postoperative pain, and maintain surgical safety. This optimization process is important for improving the efficiency and safety of ERCP surgery.