多学科参与模式下快速康复外科护理在食管癌手术患者中的应用效果

doi:10.3760/cma.j.cn441417-20250110-18026

摘要/Abstract

摘要：

目的　分析多学科参与模式下快速康复外科（ERAS）护理对食管癌（EC）胸腹腔镜联合手术患者负面情绪及术后疼痛的影响。方法　采用前瞻性研究。选择2021年5月至2023年4月南阳市中心医院接受EC胸腹腔镜联合手术的86例患者作为研究对象，按护理方法不同将所有纳入对象分为常规组（43例）和ERAS组（43例）。常规组：男23例，女20例，年龄42～72（57.89±7.05）岁，采用常规护理。ERAS组：男25例，女18例，年龄42～73（58.05±6.96）岁，采用多学科参与模式下ERAS护理。两组均干预3个月。对比两组干预前后的临床指标、负面情绪［焦虑自评量表（SAS）、抑郁自评量表（SDS）］、视觉模拟评分法（VAS）评分，以及并发症发生率。统计学方法采用χ²检验、t检验。结果　ERAS组下床活动时间、肛门排气时间和住院天数均较常规组短［（52.25±5.36）h比（78.16±7.29）h、（47.52±4.23）h比（72.36±6.58）h、（8.25±0.56）d比（9.76±0.68）d］，差异均有统计学意义（t=18.777、20.823、11.240，均P<0.05）；ERAS组干预后SAS、SDS、VAS评分均较常规组低［（18.95±1.68）分比（26.74±2.35）分、（17.32±1.62）分比（25.46±2.41）分、（2.03±0.25）分比（3.87±0.42）分］，差异均有统计学意义（t=17.683、18.382、24.686，均P<0.05）。ERAS组并发症发生率低于常规组［4.65%（2/43）比18.60%（8/43）］，差异有统计学意义（χ²=4.074，P<0.05）。结论　多学科参与模式下ERAS护理应用于EC胸腹腔镜联合手术患者中，能减轻机体疼痛，改善患者负面情绪，缩短下床活动时间和住院天数，促进患者术后康复，减少并发症的发生。

关键词:

食管癌, 快速康复外科, 腹腔镜手术, 多学科诊疗, 负面情绪

Abstract:

Objective　The analysis focuses on the impact of rapid recovery surgery (ERAS) involving multiple disciplines on the negative emotions and postoperative pain of patients undergoing combined thoracoscopic and laparoscopic surgery for esophageal cancer (EC). Methods　A prospective study was adopted. A total of 86 patients who underwent combined EC thoracoscopic and laparoscopic surgery at Nanyang Central Hospital from May 2021 to April 2023 were selected as the research subjects. All the included subjects were divided into the conventional group (43 cases) and the ERAS group (43 cases) according to different nursing methods.Control group: 23 males and 20 females, aged 42 to 72 (57.89±7.05) years. They received routine care. ERAS group: 25 males and 18 females, aged 42 to 73 (58.05±6.96) years. They received ERAS care based on multidisciplinary participation.Both groups were intervened for 3 months.Compare the clinical indicators, negative emotions [Anxiety Self-Rating Scale (SAS), Depression Self-Rating Scale (SDS)], Visual Analogue Scale (VAS) scores, and the incidence of complications before and after the intervention in the two groups.Statistical methods employed were the χ² test and the t test. Results　The time for getting out of bed, the time for rectal gas release, and the length of hospital stay in the ERAS group were all shorter than those in the conventional group [(52.25±5.36) hours vs.(78.16±7.29) hours,(47.52±4.23) hours vs.(72.36±6.58) hours, and (8.25±0.56) days vs.(9.76±0.68) days], and the differences were statistically significant (t=18.777,20.823,and 11.240; all P<0.05).After the intervention in the ERAS group, the scores of SAS, SDS and VAS were all lower than those in the conventional group [(18.95±1.68) points vs.(26.74±2.35) points, (17.32±1.62) points vs.(25.46±2.41) points, and (2.03±0.25) points vs.(3.87±0.42) points], and the differences were statistically significant (t=17.683, 18.382, and 24.686; all P<0.05).The incidence of complications in the ERAS group was lower than that in the conventional group [4.65% (2/43) vs. 18.60% (8/43)], and the difference was statistically significant (χ²=4.074, P<0.05). Conclusion　The ERAS nursing care model based on multi-disciplinary participation, when applied to patients undergoing combined thoracoscopic and laparoscopic surgeries for EC, can alleviate pain in the body, improve the negative emotions of patients, shorten the time for getting out of bed and the length of hospital stay, promote postoperative recovery of patients, and reduce the occurrence of complications.

Key words:

Esophageal cancer, Rapid rehabilitation surgery, Operative laparoscopy, Multi-disciplinary team, Negative emotion

贾波唐克莉侯玲玲.

多学科参与模式下快速康复外科护理在食管癌手术患者中的应用效果 [J]. 国际医药卫生导报, 2025, 31(18): 3122-3126.

Jia Bo, Tang Keli, Hou Lingling.

Effects of enhanced recovery after surgery on patients undergoing surgery for esophageal cancer based on multidisciplinary participation [J]. International Medicine and Health Guidance News, 2025, 31(18): 3122-3126.

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