Research On Application Of Concept Of ERAS In Perioperative Nursing Of The Transurethral Bladder Tumor Resection Patients

Objective:To construct a perioperative nursing program based on ERAS concept for the transurethral bladder tumer resection patients and apply it to evaluate its application effect in clinical nursing.Methods:Based on literature review and group discussions,a preliminary ERAS perioperative nursing plan for the transurethral bladder turmer resection patients was developed.Based on this,an expert consultation questionnaire was formed,and Delphi experts were used to construct the transurethral bladder tumer resection patients.ERAS perioperative nursing program is also used in clinical nursing.A total of 98 patients with transurethral bladder turmer resection in a urological department of a tertiary Class A hospital in Nanjing.From March 2018 to November 2019 were selected,and a historical controlled study method was adopted.March 2018 to December 2018 were selected for acceptance.Forty-nine patients with transurethral bladder turmer resection were used as the control group.Forty-nine patients were used as the test group during the period from January 2019 to November 2019.The intraoperative blood loss,bowel sounds recovery time,first exhaust time,first defecation time,first time to get out of bed,length of hospital stay and total cost,complication rate(urinary tract infection,bladder spasm,postoperative bleeding,etc.),patients’ quality of life(such as before discharge,in one month after discharge and in three months after discharge)of the two groups were compared.Results:(l)Through two rounds of inquiry,the ERAS perioperative nursing plan for patients with transurethral bladder tumer resection was formed,which contained 51 items(3 items of class Ⅰ,13 items of class Ⅱ,and 35 items of class Ⅲ.Each).(2)The test group were better than the control group in the blood loss,bowel sound recovery time,postoperative first exhaust time,Postoperative defecation time,out-of-bed activity time,length of hospital stay,and total cost.The difference was statistically significant(all P<0.05).(3)The incidence of urinary tract infection in the test group was not lower than the control group.The difference was not statistically significant(P>0.05).The incidence of bladder spasm and postoperative bleeding in the test group were lower than the control group.The difference was statistically significant(P<0.05).(4)The test group scored were higher than the control group in the seven functional areas of quality of life(body function,role function,affective function,social function,cognitive function,sexual function,worry about the future)and overall health level before discharge and one month after discharge.The difference was statistically signifieant(P<0.05).The test group scored were lower than the control group in seven symptom areas of quality of life(fatigue,nausea and vomiting,pain,other symptoms,urinary tract symptoms,intestinal symptoms,treatment-related symptoms)before discharge and one month after discharge..The difference was statistically significant(P<0.05).The test group scored were higher than the control group in the three functional areas of quality of life(body function,cognitive function,sexual funetion)in three months after discharge.The difference was statistically significant(P<0.05).The test group scored were lower than the control group in the four functional areas of quality of life(role function,emotional function,social function,worry about the future)and the overall health status in three months after discharge.The difference was not statistically significant(P>0.05).The test group scored were lower than the control group in seven symptom areas of quality of life(fatigue,nausea and vomiting,pain,other symptoms,urinary tract symptoms,intestinal symptoms,treatment-related symptoms)in three months after discharge.The difference were statistically significant(P<0.05)(3)Conclusions:The constructed ERAS perioperative nursing program for the transurethral bladder turmer resection can promote the recovery of patients’ physical functions and gastrointestinal functions,shorten the number of hospital stays,reduce medical costs,reduce the incidence of bladder spasms and postoperative bleeding,reduce postoperative adverse symptoms and can promote the recovery of various body functions.lt can improve the overall health of patients,promote the establishment of good social relationships,and improve the patient’s quality of life before discharge and one month after discharge,but it can not improve the patient’s role function,emotional function,social function,worry about the future and overall health status in three months after discharge.