加速康复外科理念在儿童肝囊型棘球蚴病患者中的应用效果

Utilization of Accelerated Rehabilitation Surgical Principles in the Perioperative Care of Pediatric Patients Suffering from Hepatic Cystic Echinococcosis

摘要: 目的：研究儿童肝囊型棘球蚴病患者在围手术期护理实施加速康复外科方式的效果分析。方法：选取2015年6月~2023年2月伊犁州友谊医院收治的100例肝囊型棘球蚴病患者作为研究对象，2015年6月至2020年1月期间的50例患者分为对照组(50例)，2020年2月至2023年2月的50例患者分为干预组(50例)，对照组采用传统的外科护理方法，干预组采用加速康复外科护理方法。比较2组的面部表情疼痛评分、住院天数、肠道初步通气时间、肠道初次排便时间、尿管拔除时间、进食时间、下床活动时间及术后并发症情况。结果：干预组的面部表情疼痛量表得分、术后肠道初次通气时间、肠道初次排便时间、进食开始时间、尿管拔除时间、首次下床活动时间、手术后住院时间均低于对照组，差异有统计学意义(P < 0.05)，在术后并发症方面，干预组的发生例数为3例(包括2例残腔积液和1例胸腔积液)，而对照组则5例(4例残腔积液及1例胸腔积液)，两组并发症发生率比较，差异无统计学意义(P > 0.05)。结论：干预组的患者相比对照组在多方面表现出改善，包括疼痛明显减轻、肠道首次排气和排便的时间提前，以及手术后的住院时间大幅度缩短。此外，他们下床活动和进食的时间也有所提前，恢复速度较快。虽然观察到干预组并发症的数量少于对照组，但未发现两组并发症发生率存在统计学差异。本研究结果支持加速康复外科护理在儿童肝囊型棘球蚴病围手术期管理中的应用价值，其在改善术后恢复指标方面效果明确，具有广泛的推广价值。

Abstract: Objective: To analyze the effect of implementing enhanced recovery after surgery (ERAS) in the perioperative nursing care of children with hepatic cystic echinococcosis. Methods: A total of 100 patients with hepatic cystic echinococcosis admitted to Yili Prefecture Friendship Hospital from June 2015 to February 2023 were selected as the research subjects. Fifty patients from June 2015 to January 2020 were divided into the control group (50 cases), and 50 patients from February 2020 to February 2023 were divided into the intervention group (50 cases). The control group received traditional surgical nursing methods, while the intervention group received enhanced recovery after surgery nursing methods. The facial expression pain scores, length of hospital stay, initial intestinal ventilation time, first defecation time, urinary catheter removal time, eating time, ambulation time after getting out of bed, and postoperative complications were compared between the two groups. Results: The scores of the facial expression pain scale, initial postoperative intestinal ventilation time, first defecation time, starting time of eating, urinary catheter removal time, first ambulation time after getting out of bed, and postoperative hospital stay in the intervention group were all lower than those in the control group, and the differences were statistically significant (P < 0.05). In terms of postoperative complications, the number of cases in the intervention group was 3 (including 2 cases of residual cavity effusion and 1 case of pleural effusion), while that in the control group was 5 (4 cases of residual cavity effusion and 1 case of pleural effusion). The incidence of complications in the intervention group was significantly lower than that in the control group, but the difference was not statistically significant (P > 0.05). Conclusion: Compared with the control group, patients in the intervention group showed improvements in many aspects, including significantly reduced pain, earlier first intestinal exhaust and defecation times, and a substantial shortening of the postoperative hospital stay. In addition, their time to get out of bed for activities and start eating was also advanced, with a faster recovery rate and a lower risk of postoperative complications, which has broad promotion value.