快速康复理念联合基于现象学分析法的健康干预在肝胆胰疾病患者围术期的应用

摘要
图/表
参考文献
相关文章 (2)

全文: PDF (2462 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨快速康复理念（enhanced recovery after surgery,ERAS）联合基于现象学分析法的健康干预在肝胆胰疾病患者围术期的应用效果。方法: 选取我院2021年1月―2023年1月肝胆胰疾病手术患者161例,根据非随机临床同期对照研究以及患者自愿原则分为对照组76例（常规干预）和干预组85例（快速康复理念联合基于现象学分析法的健康干预）。对比两组术后首次排便时间、下床活动时间、住院时间、住院费用、术后疼痛程度[视觉模拟评分（VAS）]、并发症发生情况、心理困扰程度和满意率。结果: 干预组首次排便时间、下床活动时间、住院时间均短于对照组,住院费用少于对照组;术后3 d及8 d干预组VAS评分低于对照组;干预组术后并发症总发生率低于对照组;术后1个月干预组中重度心理困扰程度占比低于对照组;术后1个月后干预组总满意率高于对照组。结论: 快速康复理念联合基于现象学分析法的健康干预在肝胆胰疾病患者围术期的应用效果显著,能促进患者术后恢复,减轻患者治疗经济负担,缓解患者术后疼痛及不良心理状态,降低术后并发症发生率,患者满意率高,值得临床应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	彭潇潇
	童钟
	潘爱红

关键词 ：快速康复理念, 现象学分析法, 健康宣教, 肝胆胰疾病, 围术期

Abstract：Objective To explore the application effect of enhanced recovery after surgery (ERAS) combined with phenomenological analysis-based health management in perioperative period of patients with hepatobiliary and pancreatic diseases. Methods 161 patients with hepatobiliary and pancreatic disease surgery from January 2021 to January 2023 were selected and classified into control group (76 cases, routine intervention) and intervention group (85 cases, ERAS combined with phenomenological analysis-based health intervention) by the non-randomized clinical concurrent control study and voluntary principle of patients. The first defecation time, ambulation time, hospital stay, hospitalization cost, postoperative pain degree [visual analogue scale (VAS) ], complications, psychological distress degree and satisfaction rate were compared between groups. Results The first defecation time, ambulation time and hospital stay in intervention group were shorter, and the hospitalization cost was less compared to control group. The VAS scores in intervention group at 3 and 8 days after surgery were lower than those in control group. The intervention group had lower total incidence rate of postoperative complications. The proportion of moderate-severe psychological distress degree was lower in intervention group at 1 month after surgery. At 1 month after surgery, the total satisfaction rate in intervention group was higher compared with that in control group. Conclusion ERAS combined with phenomenological analysis-based health intervention has a significant application effect in perioperative period of patients with hepatobiliary and pancreatic diseases, and it can promote the postoperative recovery, alleviate the treatment economic burden, relieve the postoperative pain and adverse psychological status, and reduce the incidence rates of postoperative complications, and it has high satisfaction rate.

Key words： enhanced recovery after surgery phenomenological analysis health education hepatobiliary and pancreatic diseases perioperative

收稿日期: 2024-04-11

中图分类号:

R473.6

基金资助:安徽省卫健委财政重点项目“ALYREF通过P13K-Akt/NF-kB信号轴调控肝细胞癌生长转移的作用研究”(K2023-025)

通讯作者: 彭潇潇,E-mail：pengxiaoxiao0613@126.com

引用本文:

彭潇潇, 童钟, 潘爱红. 快速康复理念联合基于现象学分析法的健康干预在肝胆胰疾病患者围术期的应用[J]. 湖南师范大学学报(医学版), 2024, 21(3): 157-160. PENG Xiaoxiao, TONG Zhong, PAN Aihong. Application of enhanced recovery after surgery combined with phenomenological analysis-based health intervention in perioperative period of patients with hepatobiliary and pancreatic diseases. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(3): 157-160.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I3/157

[1] GU LL, ZHANG XJ, LI J, et al.[Practice and application of enhanced recovery after surgery in perioperative period of liver operation][J]. National Medical Journal Of China, 2019, 99(26): 2052-2056.
[2] ZHANG S, YANG Y, LIU W, et al.Effects of Nursing Care Using a Fast-Track Surgery Approach in 49 Patients with Early-Stage Hepatocellular Carcinoma Undergoing First-Line Treatment with Radiofrequency Ablation: A Retrospective Study[J]. Med Sci Monit, 2023, 29: e939044.
[3] JOLIAT GR, KOBAYASHI K, HASEGAWA K, et al.Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022[J]. World J Surg, 2023, 47(1): 11-34.
[4] 汪晓娜, 方晓华, 陈小萍. 基于现象学分析法的健康教育对前列腺癌手术患者心理困扰、遵医行为依从性、性功能的影响[J]. 中国性科学, 2023, 32(12): 37-40.
[5] 曾纯, 吴燕, 巫倩英. 加速康复外科护理在肝胆胰围手术期中的应用[J]. 护理实践与研究, 2018, 15(24): 71-72.
[6] 刘畅, 杨莉, 马宁, 等. 工娱治疗对围手术期肺癌患者症状困扰和心理韧性的干预效果研究[J]. 中国实用护理杂志, 2022, 38(36): 2851-2856.
[7] 苏彩玲, 张萍. 优质护理在预防肝胆胰恶性肿瘤患者围术期下肢静脉血栓形成中的效果[J]. 血栓与止血学, 2021, 27(3): 518-519.
[8] 李天洋, 陈汝福, 古维立. 加速康复外科理念下肝胆胰手术腹腔引流管的精准管理[J]. 中华普通外科杂志, 2023, 38(5): 387-392.
[9] 孟燕, 熊存锦, 刘美辰. 基于ERAS理念的HAPA模型健康教育在肝切除术中的应用效果[J]. 安徽医学, 2023, 44(4): 464-469.
[10] 周毅峰, 杨继平. 日间手术患者健康教育需求的质性研究[J]. 中国现代手术学杂志, 2021, 25(4): 310-315.
[11] ELSENOSY AM, HASSAN E, ABDELGADER M, et al.Enhanced Recovery After Surgery (ERAS) Approach: A Medical Complex Experience[J]. Cureus, 2023, 15(12): e51208.
[12] NOBA L, RODGERS S, CHANDLER C, et al.Enhanced Recovery After Surgery (ERAS) Reduces Hospital Costs and Improve Clinical Outcomes in Liver Surgery: a Systematic Review and Meta-Analysis[J]. J Gastrointest Surg, 2020, 24(4): 918-932.
[13] 卢俊梅. 围术期综合护理模式对胆囊结石手术患者疼痛及预后的影响[J]. 国际护理学杂志, 2019, 38(19): 3207-3209.
[14] PANG Z, WANG X, WU Y, et al.Construction and Empirical Study of Nursing Quality Evaluation Index System of Hepatobiliary Surgery Based on ERAS Concept[J]. Comput Math Methods Med, 2022, 2022: 1117880.
[15] 赵书涵, 朱秋明, 李姗姗, 等. 护理人员基于微信公众平台对PICC带管患者实施健康教育体验的质性研究[J]. 中国实用护理杂志, 2019, 35(27): 2144-2148.
[16] 李碧波, 刘涛, 李娜. 加速康复外科理念在行脊柱融合术腰椎退行性疾病患者护理中的应用[J]. 新乡医学院学报, 2022, 39(11): 1068-1073.
[17] 张英, 郭敬, 杨凤霞, 等. ERAS理念下护理健康教育路径在腹腔镜肝叶切除围手术期的应用[J]. 昆明医科大学学报, 2021, 42(4): 168-171.
[18] 许娜, 曹晓刚, 方兴超. 舒适护理对中老年腹腔镜胆囊切除术后疼痛程度及健康行为能力的影响[J]. 中国医药导报, 2023, 20(28): 189-192.
[19] 郭燕杰, 董雪, 程兆华, 等. 复发性急性胰腺炎患者疾病认知的质性研究[J]. 中华现代护理杂志, 2023, 29(15): 2039-2044.
[20] 赵洋洋, 潘文彦, 周子琳, 等. 肝移植受者支持性照护需求的质性研究[J]. 中华护理杂志, 2023, 58(22): 2741-2746.