Construction And Preliminary Application Of Postoperative Rehabilitation Nursing Program For Patients With Chronic Subdural Hematoma Under The Concept Of Rapid Rehabilitation

Research Purpose:Construct the postoperative rehabilitation nursing plan for patients with chronic subdural hematoma under the concept of accelerated recovery,and compare the various indicators of patients under the clinical application and conventional nursing mode to verify the effectiveness and safety of ERAS,and provide clinical care for chronic subdural hematoma.Provide rationale and support programs for patients with hematoma.Research Methods:Through literature review,clinical investigation,research group discussion and Delphi expert correspondence,a nursing plan for patients with chronic subdural hematoma under the concept of enhanced recovery was constructed.The nursing plan for patients with chronic subdural hematoma during drilling and drainage operation under the concept of accelerated recovery was applied to clinical practice,and 216 patients who underwent drilling and drainage surgery in the Neurosurgery Department of Huzhou First People’s Hospital from July 2019 to December 2021 were selected.Patients with chronic subdural hematoma were randomly divided into control group（n=108）and enhanced recovery surgery group（ERAS group,n=108）.Nursing care during surgery.The scores of anxiety,pain,self-care ability,postoperative hospitalization time,total hospitalization cost,incidence of complications（cranial infection,hematoma recurrence,delirium）,readmission rate within 30 days and total hospitalization cost were compared between the two groups of patients and patient and physician satisfaction with nursing.Research Results:After two rounds of inquiry by Delphi experts,a nursing program for ERAS patients with chronic subdural hematoma was constructed,including 3 primary indicators,7 secondary indicators and 17 tertiary indicators.There were no significant differences in gender,age,educational level,marital status,nutritional status,smoking history and drinking history between the two groups（P ≥ 0.05）,which were comparable.The intervention effect of the nursing program for patients with ERAS chronic subdural hematoma during the operation period shows: the physical and mental recovery of the two groups of patients during the operation period:（1）The "anxiety" score between the ERAS group and the control group was statistically different at 1 day before operation,1 week after operation and at discharge.There were significant differences（P<0.05）;（2）the "pain" score of the ERAS group was significantly different from that of the control group at 12 h,24h,and 48 h after operation（P<0.05）;Compared with the control group,there was a statistically significant difference（P<0.05）.Results of clinical indicators: After intervention,the incidence of postoperative complications（cranial infection,hematoma recurrence,delirium）,length of hospital stay and total hospitalization expenses were compared between the two groups,and the differences were statistically significant（P<0.05）.Comparing the satisfaction with nursing work,the difference was statistically significant（P<0.05）.Research Conclusion:Enhanced recovery after surgery for patients with chronic subdural hematoma during the operation period can reduce anxiety,reduce postoperative pain,improve self-care ability of daily life,reduce postoperative complications,shorten postoperative hospitalization time,reduce medical expenses,and improve Patient and physician satisfaction with nursing work,and its clinical application is safe,effective,and feasible.