多模式护理干预对腹部手术患者增强康复的效果

H. Barboza, Fatima Dsilva, M. Moosaba, A. Lobo
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摘要

背景:围手术期包括各种程序,旨在为患者做好身体和心理准备,预防术后并发症,从而缩短住院时间。目的:本研究包括应用各种措施来鼓励患者积极参与和迅速参与强化康复。材料和方法:采用准实验设计,评估在曼加卢鲁一家三级护理医院接受腹部手术的患者中,干预措施对增强恢复的有效性。选择20至60岁接受腹部手术的患者作为参与者。结果:根据亚洲人群的BMI类别,实验组和对照组的大多数参与者(40%)属于正常体重指数(BMI)18.5-24.9 Kg/m2的类别。术后第2天和第3天,实验组和对照组的肺活量评分有显著差异(P<0.05)。因此,深呼吸练习对改善肺功能是有效的。在实验组中,60%的患者在手术后6小时内接受了口服喂养。实验组和对照组的术后住院时间比较显示,两组之间有显著差异(p<0.05),实验组的平均术后住院天数为4天。结论:强化手术恢复方案提供了更快的恢复率和更少的术后并发症。这些多模式干预措施在常规实践中对接受腹部开放手术的患者的最佳围手术期护理是有用的。
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Effectiveness of multimodal care interventions on enhanced recovery among the patients undergoing abdominal surgery
Background: The perioperative phase includes a variety of procedures that aim to prepare the patient, physically and psychologically and prevent postoperative complications, thereby reducing the length of hospital stay. Objectives: This study includes the application of various measures to encourage active involvement and prompt participation of the patients in the enhanced recovery. Materials and Methods: A quasi-experimental design was used to evaluate the effectiveness of interventions on enhanced recovery among patients undergoing abdominal surgery at a tertiary care hospital, Mangaluru. Patients undergoing abdominal surgery between 20 to 60 years were selected as participants. Results: The majority of the participants (40%) belonged to the category of normal Body Mass Index (BMI) of 18.5-24.9 Kg/m2 in the experimental group and control group as per BMI categories for Asian populations. There was a significant difference in vital capacity scores between the experimental and control groups (P<0.05) on postoperative days 2 and 3. Thus it proved that deep breathing exercises are effective in improving pulmonary functions. In the experimental group, 60% received oral feed within 6 hours of surgery. The comparison of length of postoperative hospital stays in the experimental and control groups showed a significant difference between the groups (p<0.05) and the average postoperative hospital stay was 4 days in the experimental group. Conclusion: The enhanced surgery recovery protocol provides a faster recovery rate and fewer postoperative complications. These multimodal interventions are useful in routine practice for the optimal perioperative care for patients undergoing open abdominal surgery.
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