关键词: 结核, 腹腔, 外科手术, 康复护理

Abstract:

Objective: To explore the application value of enhanced recovery after surgery (ERAS) model in perioperative period of patients with abdominal tuberculosis. Methods: A retrospective analysis was made on 107 patients with abdominal tuberculosis who were admitted to the Tuberculosis Surgery Department of Shaanxi Provincial Tuberculosis Prevention and Control Hospital from January 2015 to December 2020. Among them, 49 patients with abdominal tuberculosis admitted from January 2015 to June 2018 received routine perioperative care as the control group; from July 2018 to December 2020, 58 patients undergoing abdominal tuberculosis surgery were integrated into the ERAS management mode on the basis of routine nursing measures as the ERAS group. The differences between the two groups at the time of admission, and postoperative ambulation time, postoperative 72 hours pain score, average hospitalization days, the time of exhaust, defecation, gastric tube removal, drainage tube removal, complications, postoperative body mass index, satisfaction rate were compared. Results: In the postoperative ERAS group, postoperative ambulation time, postoperative 72 h pain score, average hospitalization days ((21.93±0.75) h, (3.17±1.17) points, (34.38±3.20) d) were lower than the control group ((24.51±4.67) h, (3.86±1.79) points, (35.90±4.17) d), the differences were statistically significant (t=4.152, P<0.001; t=2.373, P=0.019; t=2.131, P=0.035). The time of exhaust, defecation, gastric tube removal, drainage tube removal, and complications in the ERAS group ((2.12±0.73) d,(4.00±0.73) d,(5.29±1.08) d,(12.84±3.54) d,10.34% (6/58)) were lower than those in the control group ((2.57±0.58) d, (4.55±0.58) d, (7.02±1.79) d, (14.65±3.94) d, 28.57%(14/49)).The difference was statistically significant (t=0.440, P=0.001; t=0.440, P<0.001; t=5.056, P<0.001;t=2.502, P=0.014; χ²=5.805, P=0.016). The body mass index and satisfaction rate of ERAS group were (20.30±1.12) points and 96.55% (56/58), respectively, which were higher than those of the control group ((18.76±1.38) points and 85.71% (42/49)), the difference was statistically significant (t=0.546, P<0.001; χ²=4.049, P=0.044). Conclusion: The application of ERAS management mode in the perioperative period of patients with abdominal tuberculosis can promote the recovery of patients, reduce postoperative pain, shorten hospitalization time, reduce complications and improve patient satisfaction.

Key words: Tuberculosis, Abdominal cavity, Surgery, Rehabilitation nursing