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ERAS理念在经尿道钬激光前列腺剜除术围手术期及延续护理中应用的观察
杜雪立
天津医科大学第二医院泌尿外科天津 300211
摘要:
目的:观察对经尿道钬激光前列腺剜除术(holmium laser enucleation of the prostate,HoLEP)的患者在围手术期及延续护理中应用加速康复外科( enhanced recovery after surgery,ERAS)理念的相关护理措施的效果。方法:选取天津医科大学第二医院泌尿外科 2019年 1月—2019年 6月收治的行 HoLEP的良性前列腺增生患者为研究对象,按时间顺序分为观察组和对照组,观察组 83例按照 ERAS理念给予围手术期护理和延续护理,对照组 82例在围手术期和术后给予常规护理,评价不同护理效果。结果:与对照组相比,观察组患者的首次肛门排气时间、首次进食时间、下床活动时间、尿管留置时间及住院时间均明显缩短(P< 0.05);术后第 1天、第 4天的 IPSS评分、VAS评分较对照组低,Qmax较对照组高(P< 0.05);术后随访 1个月和 3个月后观察组患者的 IPSS评分、AUA-SS及 QOL均低于对照组(P< 0.05);并发症发生率较对照组降低,护理满意度高于对照组,差异有统计学意义( P< 0.05)。结论:对 HoLEP患者应用 ERAS理念进行围手术期及延续护理能够促进患者快速康复,改善长期预后,减少并发症的发生,提高患者满意度。
关键词:  前列腺增生  钬激光前列腺剜除术  加速康复外科  围手术期护理  延续护理  经尿道
DOI:10.3969/j.issn.1007-6948.2020.04.034
投稿时间:2020-04-05
基金项目:
Research on ERAS Nursing Concept in Perioperative and Continuing Nursing of Transurethral Holmium Laser Prostatectomy
DU Xue-li
Department of Urology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China
Abstract:
Objective To explore the application effect of nursing measures based on the concept of accelerated recovery after surgery (ERAS) in perioperative and continuous nursing of patients undergoing transurethral holmium laser enucleation of the prostate (HoLEP), optimizing the quality of clinical care.  Methods Patients with benign prostatic hyperplasia who underwent transurethral holmium laser prostatectomy for urinary surgery in the second hospital of Tianjin Medical University from January 2019 to June 2019 were selected as research objects, and they were divided into experimental group and control group in chronological order. In the experimental group, 83 cases were given perioperative nursing and extended care in accordance with the concept of accelerated rehabilitation surgery.82 cases in the control group were given routine nursing during the perioperative and postoperative periods. Then we evaluate different nursing effects. Results In the observation group,the time of the ?rst anal exhaust, the time of the ?rst meal, the time of getting out of bed, the time of urinary indwelling and the length of hospitalization were signi?cantly shorter than those in the control group (P<0.05).Compared with the control group, the IPSS score and VAS score were lower than those of the control group and Qmax was higher than that of the control group on the first and fourth day after surgery (P<0.05). The IPSS scores, AUA-SS and QOL were lower than those in the control group at 1 and 3 months postoperative follow-up (P<0.05). The complication rate in the observation group was lower than that in the control group and the nursing satisfaction was higher than that in the control group, which the difference was statistically signi?cant (P<0.05). Conclusion Applying the concept of ERAS for perioperative and continuous care can improve the postoperative recovery and reduce postoperative complications of HoLE Ppatients, which improves the patients' long-term prognosis and increases the satisfaction degree of nursing care.
Key words:  Benign prostatic hyperplasia  Holmium laser enucleation of the prostate  enhanced recovery after surgery  perioperative nursing  extended nursing

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