卢丽英 戴婷婷 殷莉

【摘要】 目的：探討腹膜前腹腔镜腹股沟疝修补术（TAPP）围手术期患者采用基于加速康复外科（ERAS）的优质护理效果。方法：选取2021年1月—2023年10月常熟市第一人民医院收治的共计100例接受TAPP患者，以随机数字表法分成干预组（50例）与对照组（50例），对照组采用常规护理，干预组采用基于ERAS的优质护理，两组均干预至患者出院，比较两组围手术期指标、情绪状态、自我护理能力、生活质量。结果：干预组首次排气、术后下床活动均早于对照组，住院时间较对照组短，差异均有统计学意义（P<0.05）；干预后两组汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分均下降，干预组均较对照组低，差异均有统计学意义（P<0.05）；干预后两组自我护理能力量表（ESCA）各维度评分均升高，干预组均较对照组高，差异均有统计学意义（P<0.05）；干预后两组世界卫生组织生存质量测定量表简表（WHOQOL-BREF）各维度评分均升高，干预组均较对照组高，差异均有统计学意义（P<0.05）。结论：基于ERAS的优质护理应用于TAPP围手术期患者中，能够缩短围手术期恢复时间，改善情绪状态，提高自我护理能力及生活质量。

【关键词】 加速康复外科 优质护理 腹膜前腹腔镜腹股沟疝修补术 围手术期

Research on the Application of High-quality Nursing Based on ERAS in the Perioperative Period of TAPP/LU Liying， DAI Tingting， YIN Li. //Medical Innovation of China， 2024， 21（07）： -105

[Abstract] Objective： To explore the effect of high-quality nursing based on enhanced recovery after surgery （ERAS） on perioperative patients undergoing laparoscopic transabdominal preperitoneal herniorrhaph （TAPP）. Method： A total of 100 TAPP patients from January 2021 to October 2023 who were admitted in Changshu First People's Hospital were selected， and randomly divided into the intervention group （50 cases， high-quality care based on ERAS） and the control group （50 cases， routine care）. Both groups were intervened until the patients were discharged. The perioperative indicators， emotional status， self-care ability， and quality of life in both groups were compared. Result： The first exhaust and postoperative ambulation in the intervention group were earlier than those in the control group， and the hospitalization time was shorter than that in the control group， the differences were statistically significant （P<0.05）. After intervention， Hamilton anxiety scale （HAMA） and Hamilton depression scale （HAMD） scores in both group were decreased， and in comparision of the control group， the intervention group were lower， with statistically significant differences （P<0.05）. After intervention， the exercise of self-care ability scale （ESCA） all dimensions scores in both groups were increased， and in comparision of those in the control group， those in the intervention group were higher， with statistically significant differences （P<0.05）. After intervention， the WHO quality of life-BREF scale （WHOQOL-BREF） all dimensions scores in both groups were increased， and in comparision of those in the control group， those in the intervention group were higher， with statistically significant difference （P<0.05）. Conclusion： The application of high-quality nursing based on ERAS in TAPP perioperative patients can shorten the recovery time， improve emotional state， enhance self-care ability and quality of life.

[Key words] Enhanced recovery after surgery High quality care Laparoscopic transabdominal preperitoneal herniorrhaph Perioperative period

First-author's address： Department of General Surgery， Changshu First People's Hospital， Changshu 215500， China

doi：10.3969/j.issn.1674-4985.2024.07.024

腹股沟疝作为成人最常见的腹外疝，多发于腹股沟区域，常采用手术修复治疗[1]。腹膜前腹腔镜腹股沟疝修补术（TAPP）作为一种微创手术，能够加速术后恢复，有效解除疾病威胁，避免出现肠梗阻及肠管坏死等情况，但是患者在手术过程中为清醒状态，容易出现焦虑、恐惧情绪状态，对手术效果造成影响[2]。常规护理模式固定，容易忽略患者内心需求，引发术后应激反应，影响手术效果[3]。基于加速康复外科（ERAS）的优质护理将循证医学作为基础，将术后恢复作为重点，完善术前准备、术中及术后护理对策，使干预方案规范性提高，让患者身心狀态保持稳定[4]。本研究对100例TAPP围手术期患者进行分析，旨在探讨基于ERAS的优质护理的应用效果，详情如下。

1 资料与方法

1.1 一般资料

选取2021年1月—2023年10月常熟市第一人民医院收治的共计100例TAPP围手术期患者。……