基于循证护理制定加速康复外科的集束化护理策略在普外科患者的应用分析

Application Analysis of Clustered Nursing Strategies for Accelerated Rehabilitation Surgery Based on Evidence-Based Nursing in General Surgery Patients

摘要: 目的：探讨基于循证护理制定加速康复外科(Accelerated rehabilitation surgery, ERAS)的集束化护理策略在普外科患者的应用效果。方法：研究对象选取2018年2月到2020年2月间我院普外科术后患者108例，采用随机数字法将其分为对照组和试验组，各54例。对照组予常规加速康复外科护理，试验组予基于循证护理制定加速康复外科的集束化护理策略。比较两组患者下床活动时间、住院时间；比较两组患者术后第3 d的改良Barthel指数评分；比较两组患者术后视觉模拟评分(VAS)；统计两组患者术后感染并发症发生情况。结果：试验组患者住院时间、首次下床活动时间均显著少于对照组，差异均具有统计学意义(P < 0.05)。术后3 d，试验组患者改良Barthel指数评分显著高于对照组，差异具有统计学意义(P < 0.05)。术后1 d、3 d，两组患者VAS评分比较，差异均无统计学意义(P > 0.05)。两组患者术后感染并发症发生率比较，差异无统计学意义(P > 0.05)。试验组患者护理依从性明显优于对照组(P < 0.05)。结论：基于循证护理制定ERAS的集束化护理策略应用于普外科患者围手术期，可明显加快患者首次下床时间，提高日常生活活动能力，缩短住院时间，减少感染并发症发生率。

Abstract: Objective: To explore the application effect of cluster nursing strategy for accelerated rehabilitation surgery (ERAS) based on evidence-based nursing in patients with general surgery. Methods: A total of 108 patients after general surgery in our hospital from February 2018 to February 2020 were selected as research objects, and they were divided into control group and experimental group by random number method, with 54 cases in each group. The control group was given routine acceler-ated rehabilitation surgery nursing, and the experimental group was given cluster nursing strategy of accelerated rehabilitation surgery based on evidence-based nursing. The time of ambulation and length of hospital stay were compared between the two groups. The modified Barthel index scores of the two groups were compared on the third day after surgery. Postoperative visual analog scale (VAS) was compared between the two groups. The incidence of postoperative infection complica-tions in the two groups was analyzed. Results: The length of hospital stay and the first time to get out of bed in the experimental group were significantly shorter than those in the control group, with statistical significance (P < 0.05). Three days after surgery, the modified Barthel index score of the experimental group was significantly higher than that of the control group, with statistical signifi-cance (P < 0.05). 1 d and 3 d after surgery, there was no statistical significance in VAS scores be-tween 2 groups (P > 0.05). There was no significant difference in the incidence of postoperative in-fection complications between 2 groups (P > 0.05). The nursing compliance of experimental group was significantly better than that of control group (P < 0.05). Conclusions: ERAS’ cluster nursing strategy based on evidence-based nursing can significantly accelerate the time to get out of bed for the first time, improve the ability of daily living activities, shorten the length of hospital stay, and reduce the incidence of infection complications in perioperative general surgery patients.