Wu Lingfang, Cheng Haiying, Wu Liyuan, Yao Yuzhu, Li Dan, Dai Xinyi, Yao Danhua
Department of Otolaryngology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
Department of Nursing, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
Br J Hosp Med (Lond). 2025 May 23;86(5):1-16. doi: 10.12968/hmed.2024.0866. Epub 2025 May 19.
Throat cancer is a common malignant tumor in the head and neck region, with postoperative recovery influenced by various factors. The enhanced recovery after surgery-multidisciplinary team (ERAS-MDT) concept emphasizes the use of multidisciplinary collaboration to optimize preoperative, intraoperative, and postoperative care and treatment, aiming to accelerate patient recovery, reduce complications, and improve treatment outcomes. Therefore, this study aims to explore the impact of the ERAS-MDT-based nursing intervention in postoperative rehabilitation, nutritional status, and complication rates among patients undergoing total resection of laryngeal cancer. This retrospective study recruited 85 of patients who underwent total laryngectomy for laryngeal cancer at the Second Affiliated Hospital of Jiaxing University between April 2020 and February 2024. Among them, 45 patients who received team-based nursing interventions following the ERAS-MDT concept were categorized as the ERAS-MDT group. Another 40 patients who received routine nursing interventions, were randomly included in the conventional group. The study compared nutritional indicators, Patient Health Questionnaire-9 (PHQ-9) scores, Patient-Generated Subjective Global Assessment (PG-SGA) scores, and Generalized Anxiety Disorder-7 (GAD-7) scores before and after nursing intervention. Additionally, gastrointestinal function recovery, total hospitalization costs, patient satisfaction, length of hospital stay, and complication rates were evaluated for both groups. There was no statistically significant difference in nutritional status between the two groups before nursing ( > 0.05). The post-nursing hemoglobin, albumin, prealbumin, and total protein levels in the ERAS-MDT group were 125.63 ± 10.77 g/L, 44.14 ± 4.93 g/L, 261.74 ± 28.82 mg/L, and 64.83 ± 5.36 g/L, respectively. In contrast, the post-nursing hemoglobin, albumin, prealbumin, and total protein levels in the conventional group were 114.56 ± 8.96 g/L, 39.01 ± 4.81 g/L, 222.84 ± 26.98 mg/L, and 57.85 ± 5.11 g/L, respectively. All indicators in both groups were higher than before nursing levels, with the ERAS-MDT group exhibiting significantly higher levels than the conventional group ( < 0.05). The time to first mobilization (10.52 ± 2.17 hours), first bowel movement (21.41 ± 4.50 hours), and hospitalization time (11.57 ± 1.91 days) were significantly shorter in the ERAS-MDT group than those in the conventional group ( < 0.05). However, there was no statistically significant difference in total hospitalization costs ( > 0.05). Furthermore, the differences in the PHQ-9, GAD-7, and PG-SGA scores were statistically insignificant between the two groups before nursing ( > 0.05). After nursing, the PHQ-9 score (2.81 ± 0.78), GAD-7 score (6.68 ± 1.05), and PG-SGA score (4.69 ± 1.24) were significantly reduced in the ERAS-MDT group than pre-nursing levels, with the ERAS-MDT group demonstrating substantial decrease than the conventional group ( < 0.05). Moreover, the satisfaction rate was 95.56% (43 cases/45 cases) in the ERAS-MDT group and 80.00% (32 cases/40 cases) in the conventional group. However, the difference was statistically insignificant ( > 0.05). Additionally, the incidence of complications was 8.89% (4 cases/45 cases) in the ERAS-MDT group compared to 17.50% (7 cases/40 cases) in the conventional group, indicating statistically insignificant difference ( > 0.05). The ERAS-MDT concept team-based nursing intervention can improve hemoglobin, albumin, prealbumin, and total protein, promote postoperative recovery, and enhance patient satisfaction in those undergoing total laryngectomy for laryngeal cancer.
喉癌是头颈部常见的恶性肿瘤,术后恢复受多种因素影响。加速康复外科 - 多学科团队(ERAS - MDT)理念强调运用多学科协作来优化术前、术中和术后的护理与治疗,旨在加速患者康复、减少并发症并改善治疗效果。因此,本研究旨在探讨基于ERAS - MDT的护理干预对喉癌全切除患者术后康复、营养状况及并发症发生率的影响。本回顾性研究选取了2020年4月至2024年2月期间在嘉兴学院附属第二医院接受喉癌全喉切除术的85例患者。其中,45例接受基于ERAS - MDT理念的团队护理干预的患者被归为ERAS - MDT组。另外40例接受常规护理干预的患者被随机纳入常规组。该研究比较了护理干预前后的营养指标、患者健康问卷 - 9(PHQ - 9)评分、患者主观整体评定法(PG - SGA)评分和广泛性焦虑障碍 - 7(GAD - 7)评分。此外,还评估了两组患者的胃肠功能恢复情况、总住院费用、患者满意度、住院时间和并发症发生率。护理前两组患者的营养状况差异无统计学意义(>0.05)。ERAS - MDT组护理后的血红蛋白、白蛋白、前白蛋白和总蛋白水平分别为125.63±10.77g/L、44.14±4.93g/L、261.74±28.82mg/L和64.83±5.36g/L。相比之下,常规组护理后的血红蛋白、白蛋白、前白蛋白和总蛋白水平分别为114.56±8.96g/L、39.01±4.81g/L、222.84±26.98mg/L和57.85±5.11g/L。两组所有指标均高于护理前水平,且ERAS - MDT组显著高于常规组(<0.05)。ERAS - MDT组首次活动时间(10.52±2.17小时)、首次排便时间(21.41±4.50小时)和住院时间(11.57±1.91天)均显著短于常规组(<0.05)。然而,总住院费用差异无统计学意义(>0.05)。此外,护理前两组患者的PHQ - 9、GAD - 7和PG - SGA评分差异无统计学意义(>0.05)。护理后,ERAS - MDT组的PHQ - 9评分(2.81±0.78)、GAD - 评分(6.68±1.05)和PG - SGA评分(4.69±1.24)均较护理前显著降低,且ERAS - MDT组降低幅度明显大于常规组(<0.05)。此外,ERAS - MDT组的满意度为95.56%(43例/45例);常规组为80.00%(32例/40例)。然而,差异无统计学意义(>0.05)。另外,ERAS - MDT组的并发症发生率为8.89%(4例/45例),常规组为17.50%(7例/40例),差异无统计学意义(>0.05)。基于ERAS - MDT理念的团队护理干预可改善喉癌全切除患者的血红蛋白、白蛋白、前白蛋白和总蛋白水平,促进术后康复,提高患者满意度。