华西医学

华西医学

基于加速康复外科的骨科心理睡眠管理模式构建及效果评价

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目的 探讨基于加速康复外科(enhanced recovery after surgery,ERAS)构建的骨科心理睡眠管理模式在骨科患者中的应用效果。 方法 采用非同期临床对照研究,选取 2017 年 4 月—6 月入住的骨科患者 118 例作为干预组,2017 年 1 月—3 月入住的骨科患者 111 例作为对照组。对照组在住院期间采用常规的护理措施,干预组在常规护理措施的基础上,在住院期间实施基于 ERAS 的骨科心理睡眠管理模式,具体包括开展多学科协同合作管理的新模式、实施骨科心理睡眠管理规范路径、全面全程心理睡眠管理。比较两组患者入院后 24 h 内及出院前情绪、睡眠质量情况及满意度。 结果 干预前,两组患者一般资料及情绪、睡眠质量比较差异无统计学意义(P>0.05)。干预后,干预组华西心晴指数得分中位数(下、上四分位数)为 1(0,5)分,对照组得分为 2(0,6)分,两组比较差异有统计学意义(P<0.05);干预组匹兹堡睡眠质量指数得分中位数(下、上四分位数)为 4(3,7)分,对照组得分为 6(4,9)分,两组比较差异有统计学意义(P<0.05);干预组与对照组满意度分别为(96.47±2.72)、(95.52±2.79)分,差异有统计学意义(P<0.05)。 结论 基于 ERAS 的骨科心理睡眠管理模式有利于改善患者情绪障碍,提高患者睡眠质量与满意度,利于患者加速康复。

Objectives To explore the application effect of orthopedic psychological sleep management mode based on enhanced recovery after surgery (ERAS) in orthopedic patients. Methods A non-synchronous clinical controlled study was conducted. The intervention group enrolled 118 orthopedic patients who admitted to our hospital between April and June 2017, and the control group enrolled 111 orthopedic patients who admitted to our hospital between January and March 2017. The control group used routine nursing measures during hospitalization, while the intervention group implemented an ERAS-based orthopedic psychological sleep management mode based on routine nursing measures, which included carrying out a new mode of multidisciplinary collaborative management, implementing the normative path of orthopedic psychological sleep management, and implementing the comprehensive psychological sleep management. The mood, sleep quality and satisfaction of the two groups within 24 hours after admission and before discharge were compared. Results Before the intervention, there was no statistically significant difference in general data, mood or sleep quality between the two groups (P>0.05). After the intervention, the median score (the lower and upper quartiles) of the Huaxi Emotional Index of the intervention group was 1 (0, 5), while the score of the control group was 2 (0, 6); the median score (the lower and upper quartiles) of the Pittsburgh Sleep Quality Index was 4 (3, 7) in the intervention group and 6 (4, 9) in the control group; the satisfaction score in the intervention group was better than that in the control group (96.47±2.72vs. 95.52±2.79); the differences between the two groups were statistically significant (P<0.05). Conclusions The ERAS-based orthopedic psychological sleep management mode is beneficial to improve the patients’ emotional disorder, sleep quality and satisfaction. It facilitates the patients’ accelerated recovery.

关键词: 加速康复外科; 心理睡眠管理; 骨科

Key words: Enhanced recovery after surgery; Psychological sleep management; Orthopedics

引用本文: 屈俊宏, 宁宁, 李佩芳, 陈佳丽, 姚梅. 基于加速康复外科的骨科心理睡眠管理模式构建及效果评价. 华西医学, 2018, 33(9): 1168-1172. doi: 10.7507/1002-0179.201807158 复制

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