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探索多目标护理小组在使用LEER(“更少疼痛”、“早期活动”、“早期恢复正常饮食”和“安心”)模式促进术后康复中的应用。

Exploring the Application of a Multi-Targeted Nursing Group for Enhanced Recovery After Surgery Using the LEER ("Less Pain", "Early Movement", "Early Return to a Normal Diet" and "Reassurance") Model.

作者信息

Xie Qing-Yun, Yang Jie, Lei Ze-Hua, Gao Feng-Wei, Chen Bing, Jiang Kang-Yi, Xiong Hui, Yang Jie

机构信息

Department of Hepatobiliary Pancreatic Splenic Surgery, The People's Hospital of Leshan, Leshan, Sichuan, 614000, People's Republic of China.

Diagnosis and Treatment Center of Hepatobiliary Pancreatic Splenic Systemic Disease in Leshan, The Second Batch of Hepatobiliary and Pancreatic ERAS Standard Wards of Hubei Chen Xiaoping Science and Technology Development Foundation, Leshan, Sichuan, 614000, People's Republic of China.

出版信息

Int J Gen Med. 2021 Oct 27;14:7187-7196. doi: 10.2147/IJGM.S329837. eCollection 2021.

Abstract

OBJECTIVE

To explore the effects and value of establishing a multi-target nursing group (MTNG) for facilitating goal-oriented enhanced recovery after surgery (ERAS) using the LEER ("less pain", "early movement", "early return to a normal diet" and "reassurance") model.

METHODS

The clinical data of 198 patients with hepatobiliary and pancreatic malignancies were retrospectively analyzed. The patients were divided into two groups: 91 cases were collected in a traditional group, which adopted traditional perioperative care, and 107 cases were collected in an MTNG group, which adopted MTNG measures. The differences in the clinical data including postoperative recovery, unplanned readmission rate, the implementation rate of nursing measures, the degree of a patient's understanding of the disease, and patient compliance and satisfaction with nursing care during hospitalization were compared and analyzed between the two groups.

RESULTS

The MTNG group reflected a lower pain degree and hospitalization expenses (P < 0.05), earlier postoperative flatulence, earlier recommencing of a normal diet, and earlier postoperative ambulation (P < 0.05), together with a shorter postoperative indwelling catheter duration and length of hospital stay (P < 0.05). There were no significant differences in the incidence of postoperative complications and unplanned postoperative readmission rates between the two groups (P > 0.05). The implementation rate of nursing measures and the degree of patients understanding the disease, and patient compliance and satisfaction with nursing care were higher in the MTNG group (P < 0.05).

CONCLUSION

The MTNG approach, based on ERAS with the LEER model, was conducive to the safe and rapid postoperative recovery of patients, the precise and efficient implementation of ERAS measures, the improvement of medical treatment satisfaction among patients.

摘要

目的

探讨采用LEER(“更少疼痛”、“早期活动”、“早期恢复正常饮食”和“安心”)模式建立多目标护理小组(MTNG)以促进目标导向的术后加速康复(ERAS)的效果和价值。

方法

回顾性分析198例肝胆胰恶性肿瘤患者的临床资料。将患者分为两组:传统组91例,采用传统围手术期护理;MTNG组107例,采用MTNG措施。比较分析两组患者术后恢复、非计划再入院率、护理措施实施率、患者对疾病的了解程度、患者依从性及住院期间对护理的满意度等临床资料的差异。

结果

MTNG组疼痛程度和住院费用较低(P<0.05),术后腹胀出现更早,恢复正常饮食更早,术后下床活动更早(P<0.05),术后留置导尿管时间和住院时间更短(P<0.05)。两组术后并发症发生率和术后非计划再入院率无显著差异(P>0.05)。MTNG组护理措施实施率、患者对疾病的了解程度、患者依从性及对护理的满意度更高(P<0.05)。

结论

基于ERAS并采用LEER模式的MTNG方法有利于患者术后安全快速康复,有利于ERAS措施的精准高效实施,提高患者对医疗的满意度。

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