评估患者围手术期实践的依从性,增强术后恢复方案

Y. Ciğerci, S. Celebi
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引用次数: 1

摘要

ERAS是一种多模式和循证医学实践,旨在定义围手术期干预的概念,以改善术后预后。该议定书包括在手术前、手术中和手术后实施的若干要素。本研究旨在评估手术干预患者围手术期实践与ERAS协议的依从性。在这项描述性和前瞻性研究中,405名在大学医院普通外科诊所接受手术的患者创建了研究样本。在本研究中,未对纳入研究的患者进行干预的情况下,使用该方向准备的问卷来评估诊所为手术患者提供的常规围手术期实践对方案的依从性。术前向所有患者提供口头信息,并对98.5%的患者进行抗生素预防,术中选择尽可能小的手术切口,术后首选扑热息痛(99.5%)作为镇痛方法,均符合ERAS方案。如术前不给患者口服碳水化合物,禁食时间延长(10.91±4.79小时);术中选择长效麻醉剂,不采取必要措施确保患者正常体温;术后:87.7%的患者未早期开始口服营养和使用导尿不符合ERAS方案。作为研究的结果,确定临床常规围手术期应用不能充分遵守ERAS协议。
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Evaluate the compliance of perioperative practices of the patients with the enhanced recovery after surgery protocols
The Enhanced Recovery after Surgery (ERAS) protocol is a multimodal and evidence-based medical practice developed to define the concept of perioperative interventions to improve postoperative outcomes. The protocol consists of a number of elements implemented in the pre-, intra - and post-operative periods. This study aimed to evaluate the compliance of perioperative practices with the ERAS protocols in patients undergoing surgical intervention. In this descriptive and prospective study, 405 patients who underwent surgery in the General Surgery Clinic of a University Hospital created a sample of the study. In the study, where no intervention was made to the patients included in the study, the compliance of routine perioperative practices in the clinic offered to patients undergoing surgery to the protocol was evaluated using the questionnaire prepared in this direction. Procedures such as, in the preoperative period, providing verbal information to all the patients and giving antibiotic prophylaxis to 98.5% of the patients, in the intraoperative period, preferring the smallest possible surgical incision, and, in the postoperative period, using the paracetamol (99.5%) as the first choice for analgesia were compatible with the ERAS protocols. Procedures such as, in the preoperative period, not providing oral carbohydrate to any of the patients and keeping the fasting period longer period (10.91 ± 4.79 hours), in the intraoperative period, preferring anesthetic agents that are effective for a long time, and not perform the necessary practices to ensure normothermia in any of the patients, and, in the postoperative period, not starting the oral nutrition early and using urinary catheterization for 87.7% of the patients were not compatible with the ERAS protocols. As a result of the research, it was determined that the routine perioperative applications in the clinic did not sufficiently comply with the ERAS protocol.
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