Wang Weihong, Liu Ping, Zhang Qin, Jiang Ge, Zheng Hanjing, Zhang Weiwei
Operating Room, Chun'an Hospital of Traditional Chinese Medicine Hangzhou 311700, Zhejiang, China.
Department of Orthopedics, The Eighth People's Hospital of Hengshui Hengshui 253800, Hebei, China.
Am J Transl Res. 2022 Jul 15;14(7):4812-4820. eCollection 2022.
To explore the effect of fast-track surgery (FTS) based high quality nursing on orthopedic trauma.
In this retrospective study, 94 patients who received orthopedic trauma surgery in our hospital from December 2018 to November 2020 were included. The patients were assigned to a research group (n=47) or a control group (n=47) according to which nursing method they received. The control group received routine nursing, while the research group also received FTS-based high-quality nursing. Perioperative situation, quality of life score (SF-36) before and after operation, incidence of complications, pain score (VAS) at different time periods after operation, and nursing satisfaction were compared between the two groups.
There was no significant difference in operation time or blood loss between groups (P>0.05). The time to getting out of bed for the first time, time to drainage tube removal, and length of hospital stay in the research group were shorter than those in the control group (P<0.001). Repeated measurement analysis of variance revealed that the VAS score of the research group was lower than that of the control group at 1 h, 3 h, 6 h, 24 h and 48 h after operation (P<0.05). Intra-group comparison manifested that the VAS scores of both groups decreased at 1 h, 3 h, 6 h, 24 h and 48 h after operation (P<0.05). Comparison at different time points revealed that the difference was statistically significant (P<0.05). The incidence of complications in the research group (4.26%) was lower than that in the control group (17.02%; P<0.05). The satisfaction rate of nursing in the research group (93.62%) was higher than that in the control group (78.72%; P<0.05). After intervention, the level of superoxide dismutase (SOD) and glutathione (GSH) in both groups decreased with a lesser decrease in the research group. The contents of reactive oxygen species (ROS) and malondialdehyde (MDA) in groups after intervention were higher than those before intervention with a milder increase in the research group.
FTS mode can shorten the recovery time, reduce the degree of pain and the reduce the time of analgesia. It also promotes the recovery and shortens the hospital stay of patients, and improves their quality of life, with high satisfaction. This may be related to an expeditedd surgical process and reduced oxidative stress response of patients undergoing surgery under the rapid recovery surgical model.
探讨基于快速康复外科(FTS)的优质护理对骨科创伤的影响。
本回顾性研究纳入了2018年12月至2020年11月在我院接受骨科创伤手术的94例患者。根据所接受的护理方法将患者分为研究组(n = 47)和对照组(n = 47)。对照组接受常规护理,而研究组还接受基于FTS的优质护理。比较两组的围手术期情况、手术前后的生活质量评分(SF - 36)、并发症发生率、术后不同时间段的疼痛评分(VAS)以及护理满意度。
两组间手术时间和失血量无显著差异(P>0.05)。研究组首次下床时间、引流管拔除时间和住院时间均短于对照组(P<0.001)。重复测量方差分析显示,研究组术后1 h、3 h、6 h、24 h和48 h的VAS评分低于对照组(P<0.05)。组内比较表明,两组术后1 h、3 h、6 h、24 h和48 h的VAS评分均降低(P<0.05)。不同时间点比较显示差异有统计学意义(P<0.05)。研究组并发症发生率(4.26%)低于对照组(17.02%;P<0.05)。研究组护理满意度(93.62%)高于对照组(78.72%;P<0.05)。干预后,两组超氧化物歧化酶(SOD)和谷胱甘肽(GSH)水平均下降,研究组下降幅度较小。干预后两组活性氧(ROS)和丙二醛(MDA)含量均高于干预前,研究组升高幅度较小。
FTS模式可缩短恢复时间,减轻疼痛程度并减少镇痛时间。它还能促进患者康复,缩短住院时间,提高生活质量,满意度高。这可能与快速康复外科模式下手术过程加快及患者氧化应激反应减轻有关。