摘要
目的 探讨加速康复外科(ERAS)理念在体外循环心脏手术围术期护理中的应用.方法 将本院110例行体外循环心脏手术的患者作为研究对象,根据随机数字表法分为对照组给予常规护理模式,干预组在对照组护理基础上给予ERAS理念的模式,两组各55例.通过PCL-L量表比较两组术后创伤后应激障碍(PTSD)发生阳性率和症状发作程度.结果 干预组PTSD症状阳性率为3.64%(2/55),明显低于对照组的14.55%(8/55) (P<0.05).两组术后1、3个月PCL-L量表评分较术后1周均显著降低,且干预组评分较对照组显著降低(P<0.01).干预组重体验、警觉性增高、回避/麻木PTSD三大症状阳性率(9.82%、16.24%和7.10%)较对照组(16.85%、29.94%和16.02%)均显著降低(P<0.05).结论 ERAS理念应用于体外循环心脏手术围术期护理可明显降低患者PTSD症状阳性率,减轻PTSD发生发作程度,进而有助于获得良好的临床效果.
Objective To investigate the application of enhanced recovery after surgery (ERAS) concept in perioperative nursing of extracorporeal circulation cardiac surgery. Methods 110 patients undergoing cardiopulmonary bypass cardiac surgery in our hospital were randomly divided into the control group receiving routine nursing mode and the intervention group given the ERAS mode on the basis of the control group, with 55 cases in each group accorded to the random number table method. The positive rate of post - traumatic stress disorder (PTSD) and the level of symptoms after operation between the two groups were compared by the PCL-L scale. Results The positive rate of PTSD in the intervention group was 3.64%(2/55), which was significantly lower than that in the control group for 14.55%( 8/55 )(P<0.05). The scores of the PCL-L scale in the two groups 1 and 3 months after the surgery were significantly lower than those 1 week after the surgery;and the score of the intervention group was significantly lower than that in the control group (P<0.01). The positive rates of three major symptoms of PTSD in the intervention group (9.82%, 16.24% and 7」0%) were significantly lower than those in the control group (16.85%, 29.94% and 16.02%)(P<0.05). Conclusion The application of ERAS in perioperative nursing of patients undergoing extracorporeal circulation cardiac surgery can significantly reduce the positive rate of PTSD symptoms and relieve the level of PTSD symptoms, which is helpful for achieving good clinical results.
作者
肖淑立
林慧君
李清月
项梅
张敬文
XIAO Shu-li;LIN Hui-jun;LI Qing-yue;XIANG Mei;ZHANG Jing-wen(Department of Cardiac Surgery,HaiNan General Hospital, Haikou 570311, China)
出处
《中国心血管病研究》
CAS
2019年第6期560-563,共4页
Chinese Journal of Cardiovascular Research
关键词
加速康复外科
体外循环
心脏手术
护理
创伤后应激障碍
Enhanced recovery after surgery
Cardiopulmonary bypass
Cardiac surgery
Nursing
Post-traumatic stress disorder
作者简介
通信作者:林慧君,E-mail:linhuij2487@163.com.
