【摘要】 目的：探讨加速康复外科护理(ERAS)模式在行经尿道输尿管软镜钬激光碎石术(HLL-FU)肾结石患者中的应用效果。方法：选择2018年10月1日～2020年10月31日收治的350例接受HLL-FU的日间手术肾结石患者为研究对象，采用随机数字表法分为对照组和观察组各175例，对照组采取泌尿外科常规护理，观察组在对照组基础上采用ERAS护理模式；比较两组术前、术后24 h疼痛[采用疼痛视觉模拟量表(VAS)]、焦虑[采用焦虑自评量表(SAS)]、实验室检查指标(包括血红蛋白、白细胞计数及血肌酐水平),比较两组围术期指标(包括手术时间、术中出血量、肠鸣音恢复时间、术后肛门排气时间、导尿管留置时间及术后首次进食时间)、并发症发生情况及患者满意度。结果：观察组手术时间、肠鸣音恢复时间、术后肛门排气时间、导尿管留置时间及术后首次进食时间均短于对照组(P<0.01),术中出血量少于对照组(P<0.01);术后24 h,两组VAS、SAS评分均低于术前(P<0.01),且观察组低于对照组(P<0.01);术后24 h,两组血红蛋白高于术前(P<0.01)、白细胞计数和肌酐均低于术前(P<0.01),且观察组优于对照组(P<0.01);观察组并发症发生率、满意度优于对照组(P<0.01)。结论：对行HLL-FU日间手术肾结石患者在围术期实施ERAS护理模式，可有效加快患者术后康复、减轻疼痛、降低焦虑。更多还原

【Abstract】 Objective: To explore the effect of accelerated rehabilitation surgical nursing(ERAS)model in patients with kidney stones undergoing transurethral ureteroscopic holmium laser lithotripsy(HLL-FU).Methods: A total of 350 patients with kidney stones undergoing transurethral ureteroscopic holmium laser lithotripsy admitted during October 1,2018 to October 31,2020 of were selected as the research objects, by the random number table method divided into the control group and the observation group with 175 cases in each group, the control group adopted the urological routine nursing care, the observation group up on the basis of the control group adopted ERAS nursing mode; Comparison was made between the two groups on 24 h preoperative and postoperative pain by the pain visual analog scale(VAS),anxiety by the self-assessment scale on anxiety(SAS),laboratory examination indexes(including hemoglobin, white blood cell count and creatinine levels),to compare between the two groups on perioperative indicators(including operation time, intraoperative blood loss, bowel sound recovery time),postoperative anal exhaust time, catheter indwelling time and postoperative eating for the first time, complications and patients satisfaction.Results: The operation time, bowel sound recovery time, postoperative anal exhaust time, catheter indwelling time and postoperative eating for the first time were shorter in the observation group than those in the control group(P<0.01),The intraoperative blood loss was less in the observation group than that in the control group(P<0.01);24 h after surgery, the VAS and SAS scores were lower in both groups than those before operation(P<0.01),and those in the observation group were lower than those in the control group(P<0.01);24 h after surgery, the hemoglobin was higher than that in both groups before operation(P<0.01),white blood cell count and creatinine were lower than those in both groups before operation(P<0.01),and those in the observation group were better than those in the control group(P<0.01);The complication rate and the satisfaction in the observation group was better than the in the control group(P<0.01).Conclusion: Application of ERAS nursing mode HLL-FU ambulatory surgery patients with kidney stones in perioperative period, can effectively accelerate the patients postoperative rehabilitation, relieve pain, reduce anxiety.更多还原