Intervention effect of nutritional-psychological dual-wheel-driven ERAS nursing on patients in hepatobiliary surgery
Objective To investigate the intervention effects of nutritional-psychological dual-wheel-driven enhanced recovery after surgery(ERAS)nursing on nutritional status and psychological stress in patients from hepatobiliary surgery.Methods A total of 206 patients admitted to Hepatobiliary Surgery,Xianyang Central Hospital from July 2019 to June 2022 were selected as the study objects,and were divided into a control group and an observation group with 103 patients in each group by the random number table method.In the control group,there were 75 males and 28 females,aged 18-65(45.25±6.30)years,and there were 16 cases of pancreatic cancer,20 cases of gallbladder cancer,53 cases of hepatocellular carcinoma,and 14 cases of intrahepatic bile duct carcinoma.There were 73 males and 30 females in the observation group,aged 18-65(46.04±6.78)years,and there were 17 cases of pancreatic cancer,20 cases of gallbladder cancer,54 cases of hepatocellular carcinoma,and 12 cases of intrahepatic bile duct carcinoma.The control group adopted the conventional perioperative accelerated nursing program,while the observation group adopted the nutritional-psychological dual-wheel-driven ERAS nursing program(constructing a multidisciplinary team,carrying out simultaneous nutritional and psychological assessment and intervention)until 72 h after surgery.The differences in terms of demographic data,clinical data,wound healing,body weight,length of hospital stay,gastrointestinal function recovery,Nutritional Risk Screening 2002(NRS2002)score,Self-rating Anxiety Scale(SAS)score,and comprehensive line length of appetite Visual Analogue Scale(VAS)were compared between the two groups.t test,ANOVA,and x2 test were used.Results The postoperative first exhaust time,first feeding time,first defecation time,length of hospital stay,and wound healing time in the observation group were shorter than those in the control group[(14.84±4.36)h vs.(16.47±5.08)h,(11.20±2.19)h vs.(12.65±2.50)h,(48.48±6.43)h vs.(54.16±7.38)h,(9.37±2.09)d vs.(10.26±2.47)d,(6.38±2.05)d vs.(8.76±3.14)d](all P＜0.05).There was no statistically significant difference in the NRS2002 score between the two groups at admission(P＞0.05).The NRS2002 score of the observation group was lower than that of the control group 24 h before surgery and on the next day after surgery(t=2.487 and 3.481,both P＜0.05).Overall comparison:the differences among groups,time,and interactions were statistically significant(all P＜0.001).There was no statistically significant difference in the SAS score or comprehensive line length of appetite VAS between the two groups at admission(both P＞0.05).The SAS score of the observation group on the next day after surgery was lower than that of the control group at the same time point and that of the observation group at admission(both P＜0.001).The comprehensive line length of appetite VAS in the observation group on the next day after surgery was longer than that in the control group at the same time point and that of the observation group at admission(both P＜0.001).There was no statistically significant difference in the body weight of the observation group between on the next day after surgery and at admission(P＞0.05),while the body weight of the control group on the next day after surgery was lower than that at admission(t=2.205,P=0.030),and the body weight of the observation group was higher than that of the control group on the next day after surgery(t=2.197,P=0.029).Conclusion Nutritional-psychological dual-wheel-driven ERAS nursing program can effectively shorten the postoperative recovery time of gastrointestinal function in patients from hepatobiliary surgery,promote the improvement of patients'nutritional status,reduce the postoperative anxiety,promote the recovery of appetite,and avoid the postoperative weight loss,which contributes to the rapid recovery of the disease.
Enhanced recovery after surgeryHepatobiliary surgeryNutritionPsychological stress
万方数据
维普
