标题：基于ERAS理念的循证护理对肾结石手术患者的干预效果

      作者：郑莹，郭嘉瑜，罗颂颂    韶关市第一人民医院泌尿外科，广东 韶关 521000

      卷次： 2022年33卷16期

      【摘要】 目的 探讨基于加速康复外科(ERAS)理念的循证护理对肾结石手术患者的干预效果。方法 选择2019年11月至2020年11月韶关市第一人民医院泌尿外科收治的206例肾结石手术患者为研究对象，根据随机数表法将患者分为观察组和对照组各103例。对照组患者给予常规护理，观察组患者给予基于ERAS理念的护理干预，两组患者均连续接受护理干预一周。比较两组患者术后情况、术后12 h、24 h、36 h、48 h的视觉模拟评分(VAS)、护理一周后阿森斯失眠量表(AIS)、匹兹堡睡眠质量指数(PSQI)、生活质量综合评定问卷(GQOLI-74)的评分及术后并发症发生情况。结果 干预后，观察组患者的术后排气时间、下床时间、排便时间、住院时间分别为(13.19±2.24) h、(9.09±1.56) h、(18.08±2.30) h、(6.26±1.07) d，明显快(短)于对照组的(24.38±3.17) h、(16.05±2.11) h、(25.75±2.26) h、(7.80±1.32) d，差异均有统计学意义(P<0.05)；干预后，观察组患者在术后 12 h、24 h、36 h、48 h的VAS评分分别为(4.20±0.85)分、(3.82±0.41)分、(4.00±0.50)分、(4.14±0.23)分，明显低于对照组的(5.38±0.91)分、(4.64±0.58)分、(4.88±0.66)分、(5.05±0.37)分，差异均有统计学意义(P<0.05)；干预后，观察组患者的AIS、PSQI评分分别为(6.37±1.13)分、(8.79±1.24)分，明显低于对照组的(9.12±1.20)分、(11.18±1.09)分，差异均有统计学意义(P<0.05)；干预后，观察组患者的精神状态、心理功能、社交功能、家庭生活评分分别为(39.14±1.58)分、(35.02±1.57)分、(37.20±2.55)分、(39.36±2.31)分，明显高于对照组的(32.31±1.62)分、(29.15±1.63)分、(31.09±2.40)分、(32.01±2.14)分，差异均有统计学意义(P<0.05)；两组患者的术后并发症发生率比较差异无统计学意义(P>0.05)。结论 基于ERAS理念的循证护理能明显改善肾结石手术患者的术后情况，降低患者的VAS评分、AIS和PSQI评分，提升患者术后生活质量，值得在肾结石手术的临床护理中应用。
      【关键词】 肾结石手术；加速康复外科；循证护理；术后情况；生活质量；效果
      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2022）16—2173—04

Intervention effect of evidence-based nursing based on enhanced recovery after surgery concept on patientsundergoing nephrolithotomy.
ZHENG Ying, GUO Jia-yu, LUO Song-song. Department of Urology, the First People'sHospital of Shaoguan, Shaoguan 521000, Guangdong, CHINA
【Abstract】 Objective To explore the intervention effect of evidence-based nursing based on the concept of en-hanced recovery after surgery (ERAS) on patients undergoing nephrolithotomy. Methods A total of 206 patients under-going nephrolithotomy treated in Department of Urology, the First People's Hospital of Shaoguan from November 2019to November 2020 were selected as the research objects. According to the random number table method, the patientswere divided into an observation group and a control group, with 103 patients in each group. The patients in the controlgroup were given routine nursing care, and patients in the observation group were given evidence-based nursing based onERAS concept, both for one week. The postoperative conditions, Visual Analogue Scale (VAS) score at 12 h, 24 h, 36 h,and 48 h after the operation, changes in the Athens Insomnia Scale (AIS), Pittsburgh Sleep Quality Index (PSQI), Com-prehensive Quality of Life Questionnaire (GQOLI-74), and incidence of postoperative complications of the two groupswere compared. Results After intervention, the postoperative exhaust time, out-of-bed activity time, defecation time,and length of hospital stay of the observation group were (13.19±2.24) h, (9.09±1.56) h, (18.08±2.30) h, (6.26±1.07) d,which were significantly faster (shorter) than (24.38±3.17) h, (16.05±2.11) h, (25.75±2.26) h, (7.80±1.32) d of the con-trol group (P<0.05). After intervention, the VAS scores of patients in the observation group at 12 h, 24 h, 36 h, and 48 hafter the operation were (4.20±0.85) points, (3.82±0.41) points, (4.00±0.50) points, (4.14±0.23) points, which were sig-nificantly lower than (5.38±0.91) points, (4.64±0.58) points, (4.88±0.66) points, (5.05±0.37) points in the controlgroup (P<0.05). After intervention, the AIS and PSQI scores of the observation group were (6.37±1.13) points and(8.79±1.24) points, which were significantly lower than (9.12±1.20) points and (11.18±1.09) points of the control group(P<0.05). After intervention, the scores of mental state, psychological function, social function, and family life in the ob-servation group were (39.14±1.58) points, (35.02±1.57) points, (37.20±2.55) points, and (39.36±2.31) points, whichwere significantly higher than (32.31±1.62) points, (29.15±1.63) points, (31.09±2.40) points, (32.01±2.14) points in the　　　·护理·doi:10.3969/j.issn.1003-6350.2022.16.035