Objective To explore the application effect of the surgical concept of accelerated rehabilitation in perioperative care of total laryngectomy.Methods Totally 56 patients with laryngocarcinoma were categorized to the enhanced recovery after surgery (ERAS) group (n=25) and the control group (n=31). Patients in two groups both were given routine care, while patients in ERAS group also were given other procedures such as shortening fasting period, inserting gastric tube, early activity and cultivating patients' self-care ability, etc. Complications, total hospitalization fee, hospitalization time after surgery, satisfaction of patients and self-care ability of patients between two groups were compared.Results There was 1 case of pharyngeal fistula in ERAS group and 2 cases in the control group, there were 4 cases of pulmonary infection in the control group. In ERAS group, the hospitalization time after surgery (13.76±1.48) d and total hospitalization fee (37467±2232) yuan were all lower than those of the control group (t=8.861, 5.980;P<0.01). The satisfaction degree of patients in ERAS group was 88.00%, in the control group was 61.29% (χ2=5.034, P<0.05). The score of self-care ability of patients in ERAS group was (140.10±4.63), which was higher than that of the control group (t=40.594,P<0.01).Conclusions Accelerated rehabilitation can promote the postoperative recovery of patients with total laryngectomy, reduce total hospitalization fee, improve patients' satisfaction, increase patients' self-care abilities and improve patients' quality of life.

Objective To explore the effects of Barthel index assessment exercise in postoperative grading nursing among total laryngectomy patients. MethodsFrom January 2018 to June 2019, we selected 51 laryngeal carcinoma patients undergoing total laryngectomy in Otolaryngology Head and Neck Surgery at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, as subjects by convenience sampling. All of patients were divided into control group (n=24) and observation group (n=27) with the method of random number table. We compared the differences in the levels of grading nursing, compliance of early ambulation after surgery and self-care ability of patients between two groups. ResultsThere were no statistical difference in the levels of grading nursing of patients between two groups after surgery (P＞ 0.05). The compliance of early ambulation of patients after surgery in observation group was better than that in control group with a statistical difference (P＜0.05). The total score and dimension scores of self-care ability of patients in observation group were higher than those in control group one day before discharge with statistical differences (P＜0.05). ConclusionsBarthel index assessment exercise can objectively assess the activities of daily living of total laryngectomy postoperative patients, improve the compliance of early ambulation after surgery and self-care ability of patients.