Operation room nursing guided by enhanced recovery after surgery concept for patients taking laparoscopic cholecystectomy

doi:10.3760/cma.j.cn441417-20241104-10033

Abstract

Abstract:

Objective　To evaluate the effect of operating room nursing guided by the enhanced recovery after surgery (ERAS) concept for patients undergoing laparoscopic cholecystectomy. Methods　one hundred patients who underwent laparoscopic cholecystectomy at Hanzhong Central Hospital from January 2022 to January 2023 were selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 50 cases in each group. There 25 males and 25 females in the observation group; they were 35-65 (50.34±7.45) years old. There 25 males and 25 females in the control group; they were 34-66 (49.87±7.58) years old. The control group took routine nursing; in addition, the observation group took operation nursing guided by the ERAS concept. The body temperatures and scores of Visual Analogue Scale (VAS) at different time points, recovery indicators (time to tracheal extubation, anesthesia recovery room stay, time for first off-bed activity, time for first anal exhaust, time for recovery to oral intake, and hospital stay), social function [Social Disability Screening Schedule (SDSS)], psychological stress [Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and quality of life [World Health Organization Quality of Life Scale (WHO-QOL)] were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The body temperatures 1 h after anesthesia and when they entered and left the anesthesia recovery room in the observation group were higher than those in the control group [(36.23±0.18) ℃ vs. (35.21±0.23) ℃, (36.40±0.31) ℃ vs. (35.57±0.54) ℃, (36.62±0.18) ℃ vs. (36.12±0.14) ℃], with statistical differences (all P<0.05). The scores of VAS 6, 12, 24, and 72 h after the operation in the observation group were lower than those in the control group ( 7.76±1.56 vs 7.80±1.51 ., 4.48±0.71 vs. 6.57±0.87, 3.71±0.61 vs. 4.55±0.61, and 2.86±0.82 vs. 4.55±0.61), with statistical differences (all P<0.05). The time to tracheal extubation, anesthesia recovery room stay, time for first off-bed activity, time for first anal exhaust, time for recovery to oral intake, and hospital stay in the observation group were shorter than those in the control group [(55.48±7.93) min vs. (75.30±10.76) min,(115.37±16.48) min vs. (166.26±23.75) min, (14.68±2.13) h vs. (18.95±2.71) h, (23.28±3.33) h vs. (36.59±5.23) h, (18.50±2.64) h vs. (30.57±4.37) h, and (5.31±0.75) d vs. (6.58±0.96) d], with statistical differences (all P<0.05). After the intervention, the scores of SDSS, HAMA, and HAMD in the observation group were lower than those in the control group (6.96±0.99 vs. 11.17±0.09, 16.06±2.29 vs. 22.05±3.15, and 17.26±2.47 vs. 20.89±2.98), with statistical differences (all P<0.05). After the intervention, the total score of WHO-QOL in the observation group was higher than that in the control group (81.18±6.36 vs. 71.80±6.15), with a statistical difference (P<0.05). Conclusion　ERAS-guided operating room nursing for patients undergoing laparoscopic cholecystectomy can reduce their perioperative temperature fluctuation and postoperative pain, shorten recovery time, and improve their social function, psychological stress, and quality of life.

Key words: ERAS concept, , Laparoscopic cholecystectomy, , Operating room nursing, , Psychological stress

摘要：

目的　评估加速康复（ERAS）理念指导下的手术室护理在腹腔镜下胆囊切除手术患者中的应用效果。方法　选取2022年1月至2023年1月汉中市中心医院收治的100例腹腔镜下胆囊切除手术患者进行随机对照试验。将患者分为观察组和对照组，各50例。观察组：男、女各25例，年龄35～65（50.34±7.45）岁。对照组：男、女各25例，年龄34～66（49.87±7.58）岁。对照组接受常规护理，观察组在对照组基础上实施ERAS理念的手术室护理。比较两组不同时间点体温变化和疼痛状况［视觉模拟评分法（VAS）评分］、恢复指标（气管导管拔除、麻醉复苏室停留、首次下床活动、首次肛门排气、恢复进食、住院等时间）、社会功能［社会功能缺陷筛选量表（SDSS）评分］、心理应激状况［汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分］、生活质量［世界卫生组织生存质量量表（WHO-QOL）评分］的变化。采用χ2检验、t检验进行统计分析。结果　观察组麻醉1 h后、术后进入麻醉复苏室、离开麻醉复苏室体温均高于对照组［（36.23±0.18）℃比（35.21±0.23）℃、（36.40±0.31）℃比（35.57±0.54）℃、（36.62±0.18）℃比（36.12±0.14）℃］，差异均有统计学意义（均P<0.05）；观察组在术后6、12、24、72 h VAS评分均低于对照组［（7.76±1.56）分比（7.80±1.51）分、（4.48±0.71）分比（6.57±0.87）分、（3.71±0.61）分比（4.55±0.61）分、（2.86±0.82）分比（3.29±0.64）分］，差异均有统计学意义（均P<0.05）；观察组气管导管拔除、麻醉复苏室停留、首次下床活动、首次肛门排气、恢复进食、住院等时长均低于对照组［（55.48±7.93）min比（75.30±10.76）min、（115.37±16.48）min比（166.26±23.75）min、（14.68±2.13）h比（18.95±2.71）h、（23.28±3.33）h比（36.59±5.23）h、（18.50±2.64）h比（30.57±4.37）h、（5.31±0.75）d比（6.58±0.96）d］，差异均有统计学意义（均P<0.05）；干预后，观察组SDSS评分、HAMA和HAMD评分均低于对照组［（6.96±0.99）分比（11.17±0.09）分、（16.06±2.29）分比（22.05±3.15）分、（17.26±2.47）分比（20.89±2.98）分］，差异均有统计学意义（均P<0.05）；干预后，观察组WHO-QOL总分为［（81.18±6.36）分］，高于对照组［（71.80±6.15）分］，差异有统计学意义（P<0.05）。结论　ERAS理念指导下的手术室护理可有效减轻腹腔镜下胆囊切除手术患者术中体温波动和术后疼痛，缩短恢复时间，改善社会功能和心理应激状态，提高生活质量。

关键词: ERAS理念, , , 腹腔镜胆囊切除手术, , , 手术室护理, , , 心理应激

Sun Bei, Sun Fei, Wan Xinjian.

Operation room nursing guided by enhanced recovery after surgery concept for patients taking laparoscopic cholecystectomy [J]. International Medicine and Health Guidance News, 2025, 31(10): 1742-1747.

孙蓓孙菲宛新建. 加速康复理念的手术室护理在腹腔镜下胆囊结石患者中的应用研究 [J]. 国际医药卫生导报, 2025, 31(10): 1742-1747.

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