Chen Hong, Gong Li
Department of Urology, Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China.
Arch Esp Urol. 2024 Dec;77(10):1147-1154. doi: 10.56434/j.arch.esp.urol.20247710.160.
Prostate cancer (PCa) is a common malignant tumour in males, with radical prostatectomy (RP) being the typical treatment. The concept of enhanced recovery after surgery (ERAS) and Roy's adaptation model (RAM) have been proved effective and reliable nursing methods in clinical practice. However, the combined effect of these two methods on patients undergoing RP remains unclear. This study aims to analyse the application effect of ERAS combined with RAM in the perioperative period of patients receiving RP.
A total of 286 patients with PCa who underwent RP from March 2020 to May 2023 were selected in this retrospective analysis. After excluding five patients, 281 were finally included. According to the administered management methods, the patients were divided into a routine (n = 92), ERAS (n = 93), and ERAS + RAM group (n = 96). The Connor-Davidson Resilience Scale (CD-RISC) score, Quality of Life Questionnaire-Core 30 (QLQ-C30) score, recovery conditions, and the incidences of postoperative complications were compared between the three groups using the chi-square and Kruskal-Wallis tests.
Compared with the routine and ERAS groups, the ERAS + RAM group had significantly higher CD-RISC scores 1 day before surgery and 1 day before discharge and elevated QLQ-C30 scores 3 months after discharge, along with the shortest postoperative recovery time (all < 0.001). Complication incidences in the ERAS + RAM and ERAS groups were lower than those in the routine group ( < 0.05).
The ERAS concept combined with RAM can significantly improve perioperative mental health, promote postoperative recovery, and enhance the quality of life in patients with PCa undergoing RP. Therefore, this combined programme offers certain benefits in the perioperative period of RP, emphasising the value of its clinical promotion.
前列腺癌（PCa）是男性常见的恶性肿瘤，根治性前列腺切除术（RP）是其典型治疗方法。手术加速康复（ERAS）理念和罗伊适应模式（RAM）在临床实践中已被证明是有效且可靠的护理方法。然而，这两种方法对接受RP手术患者的联合效果仍不明确。本研究旨在分析ERAS联合RAM在接受RP手术患者围手术期的应用效果。
本回顾性分析选取了2020年3月至2023年5月期间接受RP手术的286例PCa患者。排除5例患者后，最终纳入281例。根据所采用的管理方法，将患者分为常规组（n = 92）、ERAS组（n = 93）和ERAS + RAM组（n = 96）。采用卡方检验和Kruskal-Wallis检验比较三组患者的康纳-戴维森心理弹性量表（CD-RISC）评分、生活质量核心问卷30项（QLQ-C30）评分、恢复情况及术后并发症发生率。
与常规组和ERAS组相比，ERAS + RAM组在术前1天和出院前1天的CD-RISC评分显著更高，出院后3个月的QLQ-C30评分升高，且术后恢复时间最短（均P < 0.001）。ERAS + RAM组和ERAS组的并发症发生率低于常规组（P < 0.05）。
ERAS理念联合RAM可显著改善围手术期心理健康，促进术后恢复，提高接受RP手术的PCa患者的生活质量。因此，该联合方案在RP围手术期具有一定益处，强调了其临床推广价值。
