Effect of nursing intervention strategies under the ERAS concept on postoperative rehabilitation in patients with prostatic hyperplasia

doi:10.3760/cma.j.issn.1007-1245.2023.07.030

Abstract

Abstract:

Objective　To explore the effect of nursing intervention under the concept of enhanced recovery after surgery (ERAS) on patients after prostatectomy. Methods　It was a prospective study. A total of 200 patients with benign prostatic hyperplasia admitted to The First Affiliated Hospital of Henan University of Science and Technology from June 2019 to July 2022 were selected, all of whom were scheduled to undergo resection. They were divided into a control group and an observation group according to the time of admission, with 100 patients in each group. The patients in both groups were male. The control group, aged (65.11±2.38) years, received routine care; the observation group, aged (64.89±2.42) years, received the nursing intervention under the ERAS concept on the basis of the control group. The postoperative rehabilitation, complications, scores of Visual Analogue Scale (VAS), Self-rating Anxiety Scale (SAS), Kolcaba General Comfort Questionnaire (GCQ), and Pittsburgh Sleep Quality Index (PSOI), and satisfaction were compared between the two groups. t test was used for the measurement data, and χ² test for the count data. Results　The time of getting out of bed for the first time, the time of catheter removal, and the length of hospital stay in the observation group were shorter than those in the control group [(19.26±2.15) h vs. (25.69±2.34) h, (35.69±9.48) h vs. (55.14±8.46) h, (5.23±0.75) h vs. (7.14±0.81) h], with statistically significant differences (t=20.234, 15.308, and 17.302; all P<0.001). The incidence of complications in the observation group was lower than that in the control group [8.0% (8/100) vs. 19.0% (19/100)], with a statistically significant difference (χ²=5.181, P=0.023). The VAS scores of the observation group on the first day and the third day after operation were (4.02±0.33) points and (2.23±0.24) points, respectively, which were lower than those of the control group [(4.54±0.41) points and (2.97±0.31) points], with statistically significant differences between the two groups (t=9.880 and 18.875; both P<0.001). The GCQ score of the observation group was higher than that of the control group at discharge [(95.68±5.68) points vs. (81.11±6.98) points], with a statistically significant difference (t=16.191, P<0.001). At discharge, the SAS and PSOI scores of the observation group were (34.68±5.18) points and (6.24±1.26) points, respectively, which were lower than those of the control group [(45.91±4.23) points and (7.12±2.15) points], with statistically significant differences (t=16.792 and 3.531; both P<0.05). The satisfaction of the observation group was higher than that of the control group [97.0% (97/100) vs. 88.0% (88/100)], with a statistically significant difference (χ²=5.838, P=0.016). Conclusion　The nursing intervention guided by the ERAS concept can alleviate the pain in patients after prostatectomy, and reduce the occurrence of complications, thereby improving the patients' sleep quality, regulating the emotional state, improving the comfort, promoting the patients' recovery, and contributing to the improvement of satisfaction.

Key words:

Prostatic hyperplasia, Pain, Sleep quality, Enhanced recovery after surgery

摘要：

目的　探究加速康复外科（ERAS）理念指导的护理干预在前列腺增生切除术后患者中的应用效果。方法　采用前瞻性研究。选取2019年6月至2022年7月河南科技大学第一附属医院收治的前列腺增生患者200例，均拟行切除手术治疗，以入院时间不同分为对照组、观察组，各100例。两组患者均为男性，对照组年龄（65.11±2.38）岁，给予常规护理；观察组年龄（64.89±2.42）岁，在对照组基础上给予ERAS理念指导的护理干预。对比两组术后康复情况，并发症发生情况，视觉模拟评分法（VAS）、焦虑自评量表（SAS）、Kolcaba简化舒适状况量表（GCQ）、匹兹堡睡眠质量指数量表（PSOI）评分及满意度。计量资料行t检验，计数资料行χ²检验。结果　观察组患者的首次下床活动时间、尿管拔除时间、住院时间均短于对照组［（19.26±2.15）h比（25.69±2.34）h、（35.69±9.48）h比（55.14±8.46）h、（5.23±0.75）h比（7.14±0.81）h］，差异均有统计学意义（t=20.234、15.308、17.302，均P<0.001）；观察组患者的并发症总发生率低于对照组［8.0%（8/100）比19.0%（19/100）］，差异有统计学意义（χ²=5.181，P=0.023）；术后1 d、术后3 d观察组的VAS评分分别为（4.02±0.33）分、（2.23±0.24）分，均低于对照组的（4.54±0.41）分、（2.97±0.31）分，两组比较差异均有统计学意义（t=9.880、18.875，均P<0.001）；出院时观察组的GCQ评分高于对照组［（95.68±5.68）分比（81.11±6.98）分］，差异有统计学意义（t=16.191，P<0.001）；出院时观察组的SAS、PSOI评分分别为（34.68±5.18）分、（6.24±1.26）分，均低于对照组的（45.91±4.23）分、（7.12±2.15）分，差异均有统计学意义（t=16.792、3.531，均P<0.05）；观察组患者总满意度高于对照组［97.0%（97/100）比88.0%（88/100）］，差异有统计学意义（χ²=5.838，P=0.016）。结论　ERAS理念指导的护理干预可缓解前列腺增生切除术后患者的疼痛感，减少并发症发生，从而改善患者的睡眠质量，调节情绪状态，提高舒适度，促进患者病情恢复，提高患者满意度。

关键词:

前列腺增生, 疼痛, 睡眠质量, 加速康复外科

Huang Yuqi, Liu Ying, Shi Gaihong.

Effect of nursing intervention strategies under the ERAS concept on postoperative rehabilitation in patients with prostatic hyperplasia [J]. International Medicine and Health Guidance News, 2023, 29(7): 1015-1020.

黄玉琪刘颖石改红.

ERAS理念指导的护理干预对前列腺增生患者术后康复的影响 [J]. 国际医药卫生导报, 2023, 29(7): 1015-1020.

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