| Objective To complete nursing path(ERAS-CNP)of the perioperative period of laparoscopic adrenal tumor resection under the concept of Enhanced Recovery After Surgery.Then to discuss the application effect of ERAS-CNP on the perioperative period of Laparoscopic adrenal tumor resectionMethods 1.Using literature review,case review,combined with his own clinical experience and senior nurses Suggestions,with the 2016 edition of clinical path as reference text,design the pre-operation ERAS of adrenal tumor resection under laparoscopic draft-CNP.Through expert consultation method and a clinical experiment,verification and revision adrenal tumor resection under laparoscopic perioperative ERAS-CNP form,specific implementation process.2.The clinical effect of ERAS-CNP in laparoscopic adrenal tumor resection was verified by means of case-control trial.Retrospective data collection selection in January 2017-June 2017 in a 3 armour hospital in wuhan city of 24 patients with laparoscopic resection of adrenal tumors,patients who meet the inclusion criteria set as control group,the traditional routine nursing.From July 2017 to December 2017,24patients who met the inclusion criteria were selected as the experimental group,and the nursing process was implemented using ERAS-CNP form.To hospital patients with two groups of patients with postoperative complications incidence(abdominal distention,fever),aeration time,pain degree,hospitalization days,hospitalization expenses and patients to nursing service satisfaction as evaluation index,carries on the statistical processing and analysis,evaluation of laparoscopic adrenal tumor resection perioperative clinical effect of ERAS-CNP.3.Statistical analysis.SPSS13.0 software package was used to analyze the data.The measurement data was compared with t test,and the counting data was used in frequency,and the chi-square test was used.P<0.05 was considered statistically significant.Results 1.Build the form and process of ERAS-CNP during laparoscopic adrenal tumor resection.Compiling standard laparoscopic adrenal tumor resection hospitalization days of 9 to 10 days(including preoperative preparation 1-2 days,postoperative rehabilitation time 8-9 days),the treatment of patients with process is divided into 1-2 days in hospital,hospital 3 days(operation),4 days in hospital(postoperative day 1),5-6 days in hospital(2-3 days),hospitalization days 7-8-(4-5days),9-10 days in hospital(hospital)six periods,or possible problems for patients are listed in"task-time"matrix format,in the strict time frame specification of nursing project,request to have performed the content of the play"√"and signed.2.There was no statistically significant difference between the two groups in terms of age,sex,payment method and previous history(P>0.05),with a balanced comparability;The postoperative abdominal distention rate of the two groups was 16.67%,compared with 41.67%in the control group,and the difference was statistically significant(χ~2=1.81,P﹤0.05);The incidence of postoperative fever in the two groups was 12.50%,compared with 33.33%in the control group,and the difference was statistically significant(χ~2=1.47,P﹤0.05);The number of patients in the two groups was 79.17%,compared with 41.67%in the control group,and the difference was statistically significant(χ~2=3.53,P﹤0.05);The incidence of moderate and severe pain in the two groups was 8.33%,compared with 33.33%in the control group,and the difference was statistically significant(χ~2=2.27,P﹤0.05);The average ength of stay the two groups were 9.55±2.12,which was lower than the control group 12.09±2.58,and the difference was statistically significant(P﹤0.05);The average hospitalization cost of the two groups were 42696.82±6986.76,which was lower than the control group 50521.91±7917.22,and the difference was statistically significant(P﹤0.05);The patients in the two groups were very satisfied with the evaluation of nursing quality satisfaction,and the experimental group was 79.17%,which was higher than41.67%in the control group,and the difference was not statistically significant(χ~2=2.70,P﹤0.05).Conclusion Through clinical empirical research,ERAS-CNP under laparoscopic adrenal tumor resection in patients with perioperative nursing is good,to standardize the behavior of the nursing in at the same time,also provide specific for the surgery patients,institutional care implementation process,in order to promote patients recovery,reduce complications and save medical resources,improve the quality of nursing service provided favorable conditions.It is worthy to be applied and popularized clinically. |
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