加速康复外科理念在X医院结直肠癌围手术期护理中的应用研究.docxVIP

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加速康复外科理念在X医院结直肠癌围手术期护理中的应用研究

【摘要】目的：验证加速康复外科（ERAS）护理在X医院结直肠癌围手术期的应用价值。方法：将2022-01至2023-06收治的84例结直肠癌手术患者随机分为两组，对照组42例接受常规护理，观察组42例实施ERAS护理路径（术前缩短禁食禁饮、免灌肠及健康教育，术中保温与精准补液，术后6h内进食、下床、多模式镇痛及早期拔管），比较两组康复效率、并发症及满意度。结果：观察组术中出血量、首次排气、下床活动及术后住院天数均优于对照组（P＜0.001），总并发症率4.8%低于对照组26.2%（P=0.007），护理满意度各维度评分均显著提高（P＜0.001）。结论：ERAS护理可加速结直肠癌患者术后康复，减少并发症并提升满意度，值得临床推广。

【关键词】加速康复外科；结直肠癌；围手术期护理

Abstract:Objective:Toverifytheapplicationvalueofenhancedrecoveryaftersurgery(ERAS)nursingintheperioperativeperiodofcolorectalcanceratXHospital.Methods:84patientswithcolorectalcancerwhowereadmittedfromJanuary2022toJune2023wererandomlydividedintotwogroups.Thecontrolgroupof42patientsreceivedroutinecare,whiletheobservationgroupof42patientsimplementedtheERASnursingpathway(shorteningfastingandfluidrestrictionbeforesurgery,avoidingenemaandhealtheducation,maintainingbodytemperatureandprecisefluidadministrationduringsurgery,allowingeating,gettingoutofbed,multimodalpainreliefandearlyextubationwithin6hoursaftersurgery),andtherehabilitationefficiency,complicationsandsatisfactionofthetwogroupswerecompared.Results:Theintraoperativebloodloss,firstdefecation,gettingoutofbedactivityandpostoperativehospitalstayintheobservationgroupwereallbetterthanthoseinthecontrolgroup(P0.001),thetotalcomplicationrateof4.8%waslowerthanthatofthecontrolgroup(26.2%)(P=0.007),andthescoresofeachdimensionofnursingsatisfactionweresignificantlyimproved(P0.001).Conclusion:ERASnursingcanacceleratethepostoperativerecoveryofcolorectalcancerpatients,reducecomplicationsandimprovesatisfaction,andisworthyofclinicalpromotion.

Keywords:EnhancedRecoveryAfterSurgery(ERAS);ColorectalCancer;PerioperativeCare

一、引言

结直肠癌是全球范围内常见的消化道恶性肿瘤，其发病率与死亡率均居高不下，严重威胁人类健康[1]。外科手术是目前治疗结直肠癌最主要的手段，传统围手术期管理因长时间禁食、机械灌肠、过度镇静及术后长