Effect of enhanced recovery after surgery nursing in patients with cervical single-door spinal canal augmentation and angioplasty
10.3760/cma.j.issn.1674-2907.2020.07.015
- VernacularTitle:加速康复外科护理在颈椎单开门椎管扩大成形术患者中的应用效果
- Author:
Jiyan JIN
1
;
Dong PANG
;
Yu SUN
;
Ruifeng XU
;
Feifei ZHOU
;
Jiamin LI
Author Information
1. 北京大学护理学院内外科护理教研室 100191；北京大学第三医院骨科，北京 100191
- Keywords:
Perioperative nursing;
Enhanced recovery after surgery;
Cervical single-door spinal canal augmentation and angioplasty;
Effect evaluation
- From:
Chinese Journal of Modern Nursing
2020;26(7):917-923
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application effect of a series of optimized nursing measures under the concept of enhanced recovery after surgery (ERAS) on the perioperative period of patients with posterior cervical single-door spinal canal augmentation and angioplasty.Methods:A retrospective cohort study design was used. From April to December 2018, using cluster sampling method, 476 patients admitted to a class third hospital for posterior cervical single-door spinal canal augmentation and angioplasty were selected as research objects. According to whether or not to implement ERAS optimization, the patients were divided into ERAS group with 100 cases and control group with 376 cases. The control group underwent routine measures such as preoperative evaluation and education, blood management, anesthesia points, surgical points, incision closure, pain management, drainage tube management, and prevention of complications. On the basis of routine measures, the ERAS group implemented optimized measures for ERAS on clinical measures such as fasting water and infusion management before surgery, postoperative diet and infusion management, bowel preparation, urinary tube management, and out of bed activities. A self-designed questionnaire was used to investigate the two groups of patients. The general information, implementation of ERAS nursing (preoperative fasting time, the preoperative water cut-off time, the time for anesthesia, the time for surgery, the amount of infusion before surgery, the amount of infusion during surgery, the amount of infusion after surgery, use of indwelling urinary catheters) , recent effect evaluation indicators [length of hospitalization, cost of hospitalization, discharge daily living ability score (Barthel index) , postoperative complications, postoperative urinary retention]and long-term effect evaluation indicators [Japan Orthopedic Association (JOA) score, Neck Disability Index (NDI) score, neck and shoulder pain VAS score, neck and shoulder stiffness and numbness VAS score, 90-day readmission rate]of the two groups were compared.Results:A total of 295 cases were included in the study, including 69 cases in the ERAS group and 226 cases in the control group. The study found that there were statistically significant differences between the two groups of patients in terms of preoperative fasting time, the preoperative water cut-off time, the amount of infusion before surgery, the amount of infusion after surgery and the use of indwelling urinary catheters ( P<0.05) . The comparison of recent effects showed that the difference in length of hospitalization and Barthel index between the two groups were statistically significant ( P<0.05) , while there was no significant difference in the incidence of postoperative complications of the two groups ( P>0.05) . The comparison of long-term effects showed that there was no significant difference in the modified JOA score, NDI score, neck and shoulder discomfort and the 90-day readmission rate in the two groups ( P>0.05) . Conclusions:The application of ERAS nursing in the perioperative period of patients with posterior cervical single-door spinal canal augmentation and angioplasty can effectively reduce patients' fasting time and water cut-off time, use of urinary catheters, which can reduce patients' hospitalization time, but has no significant effect on the long-term effect of surgery.
