【摘要】 目的:探究运用促进术后恢复理念(ERAS)在经尿道内镜黏膜下膀胱肿瘤海博刀剥离术(BT-ESD患者围手术期护理中的临床成效。方法:选取我院2015年5月至2017年5月入院的非肌层浸润性膀胱肿瘤患者98例,通过随机分组法将其分为ERAS组和对照组,每组49例。ERAS组应用ERAS理念,对照组患者护理方法为常规基础护理。两组患者均接受BT-ESD。针对术后患者恢复时间情况、术后并发症发生率等观察指标对两组患者进行对比分析。结果:术后患者饥饿程度评分,对照组轻度、中度及重度饥饿比例分别为46. 9%、49. 0%及4. 1%,饥饿严重程度显著高于ERAS组(87. 8%、12. 2%及0. 0%)(P <0. 05);而术后患者口渴程度评分,对照组的严重程度亦显著高于ERAS组(轻度、中度及重度口渴比例分别4. 1%vs 32. 6%、20. 4%vs 40. 8%、75. 5%vs 26. 5%)(P <0. 05)。进一步研究发现除术后住院时间外,ERAS组患者术后疼痛视觉模拟评分(VAS)(5. 9分vs 3. 1分)、通气时间(12小时vs 8小时)、尿管拔除时间(2. 5天vs 2天)、膀胱痉挛次数(3次vs 1. 8次)及膀胱冲洗时间(9. 0小时vs 6. 0小时)均显著优于对照组(P值均<0. 05)。结论:ERAS可以显著改善BT-ESD患者围手术期护理效果,具体体现在:缩短患者膀胱冲洗时间、尿管拔除时间、肠道通气时间;降低术后不良反应发生率,显著增加患者满意度,应在临床广泛推广应用。更多还原

【Abstract】 Objective: To explore the clinical effect of enhanced recovery after surgery( ERAS) in nursing care of bladder tumor-endoscopic submucosal dissection( BT-ESD) patients with non-muscle invasive bladder cancer( NMIBC). Methods: 98 cases of NMIBC patients,who were underwent the BT-ESD,were enrolled for this project( from May 2015 to May 2017). All the patients were grouped in the ERAS group and control group randomly. Conventional basic care was performed in control group,and the ERAS group applied the ERAS conception. The incidence rates of adverse reaction,hospitalization and recovery time were compared and analyzed between the two groups. Results: The severity of hungry and thirsty was significantly lower in the ERAS group( medium to severe thirsty rate67. 3% vs 95. 9%,medium to severe hungry rate 12. 2% vs 53. 1%). The VAS score( 5. 9 vs 3. 1 scores),time of fart( 12 vs 8 h),removal of catheter( 2. 5 vs 2 days),frequency of cystospasm( 3 vs 1. 8 times),time of bladder irrigation( 9. 0 vs 6. 0 h) in ERAS group were significantly shorter than control group( P < 0. 05). Conclusion: The application of ERAS concept in perioperative period of BT-ESD patients with NMIBC can reduce the post-operative recovery time and incidence of complications.更多还原