[1]张艳平 金姬延 刘东晖 庞冬*①（北京大学护理学院,北京009）①.腰椎后路减压融合内固定术加速康复外科对骨科护士护理的知识、信念和行为的效果分析[J].中国微创外科杂志,2021,01(2):139-144.
　Zhang Yanping,Jin Jiyan,Liu Donghui,et al.Analysis of Effect of Knowledge, Belief and Behavior of Orthopaedic Nurses on Nursing Care of Patients Undergoing Posterior Lumbar Decompression Fusion and Internal Fixation in Enhanced Recovery After Surgery[J].Chinese Journal of Minimally Invasive Surgery,2021,01(2):139-144.
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腰椎后路减压融合内固定术加速康复外科对骨科护士护理的知识、信念和行为的效果分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年2期
页码:
139-144
栏目:
临床研究
出版日期:
2021-02-25

文章信息/Info

Title:
Analysis of Effect of Knowledge, Belief and Behavior of Orthopaedic Nurses on Nursing Care of Patients Undergoing Posterior Lumbar Decompression Fusion and Internal Fixation in Enhanced Recovery After Surgery
作者:
张艳平 金姬延 刘东晖 庞冬*①（北京大学护理学院; 北京100191）①
（北京大学第三医院骨科，北京100191）
Author(s):
Zhang Yanping;  Jin Jiyan;  Liu Donghui;  et al.
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China
关键词:
加速康复外科; 内固定术; 护理; 知信行
Keywords:
Enhanced recovery after surgery (ERAS); Internal fixation; Nursing; Knowledge;  belief and behavior
文献标志码:
A
摘要:
目的探讨腰椎后路减压融合内固定术加速康复外科(enhanced recovery after surgery, ERAS)对骨科护士护理的知识、信念和行为（知信行）以及围术期安全性的影响。方法2019年8月我科开展腰椎后路减压融合内固定术ERAS，使用《外科医护人员ERAS知信行现状的调查问卷》对开展常规护理模式和ERAS模式的98名骨科护士知信行状况进行调查，分析开展EARS对患者围术期质量安全的影响。结果开展腰椎后路融合减压内固定术ERAS后，骨科护士知识得分优秀率由40.8%（40/98）提高到55.1%(54/98)（χ2=4.007，P=0.045），患者住院时间由(7.6±3.5)d缩短到(7.3±2.4)d（t=2.444,P=0.015），并发症发生率由3.3%（32/958）降至1.4%(12/883)（χ2=7.732,P=0.005）。结论开展腰椎后路融合减压内固定术ERAS有助于提高患者围术期质量安全及护士知信行状况。
Abstract:
ObjectiveTo investigate the effect of knowledge, belief and behavior of orthopedic nurses on nursing care of patients undergoing posterior lumbar decompression fusion and internal fixation in enhanced recovery after surgery (ERAS), and to evaluate the safety of ERAS management, formulation and implementation in perioperative period of spinal surgery.MethodsIn August 2019, the ERAS was implemented in our department in patients receiving posterior lumbar fusion decompression and internal fixation. The Questionnaire on the Status of ERAS on the Knowledge, Belief and Behavior of Surgical Staff were used to investigate the orthopaedic medical staff before and after the implementation of ERAS, so as to compare the effect of ERAS on the perioperative quality and safety of patients.ResultsAfter performing ERAS for lumbar posterior fusion and decompression and internal fixation, the excellent knowledge score of orthopaedic nurses increased from 40.8%(40/98) to 55.1%(54/98)(χ2=4.007,P=0.045), the average length of stay of patients decreased from (7.6±3.5) days to (7.3±2.4) days (t=2.444,P=0.015), and the complication rate decreased from 3.3%(32/958) to 1.4%(12/883)(χ2=7.732,P=0.005).ConclusionERAS for posterior lumbar fusion decompression and internal fixation is helpful to improve the perioperative quality and safety of patients and the knowledge, belief and behavior of nurses.

参考文献/References:

[1]Nelson G, BakkumGamez J, Kalogera E, et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery(ERAS) Society recommendations-2019 update. Int J Gynecol Cancer,2019,29(4):651-668.
[2]Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg,2002,183(6):630-641.
[3]Kehlet H, Wilmore DW. Fasttrack surgery. Br J Surg,2005,92(1):3-4.
[4]黄敬亨,主编.健康教育学.上海:复旦大学出版社,2011.33-36.
[5]Kalff R, Ewald C, Waschke A, et al. Degenerative lumbar spinal stenosis in older people: current treatment options. Dtsch Arztebl Int,2013,110(37):613-624.
[6]黎介寿.对Fasttrack Surgery (快通道外科)内涵的认识.中华医学杂志,2007,87(8):515-517.
[7]Hughes M, Coolsen MM, Aahlin EK, et al. Attitudes of patients and care providers to enhanced recovery after surgery programs after major abdominal surgery. J Surg Res,2015,193(1):102-110.
[8]王丹.外科医护人员对加速康复外科知信行现状的调查研究.山东大学护理学学位论文,2018.59-63.
[9]安胜利,陈平雁.量表的信度及其影响因素.中国临床心理学杂志,2001,9(4):315-318.
[10]王玲,孙胜凯,陈孝储,等.护理人员工作量影响因素现状调查问卷的编制及信效度检验.解放军预防医学杂志,2016,34(2):187-190.
[11]孙天胜,沈建雄,刘忠军,等.中国脊柱手术加速康复——围术期管理策略专家共识.中华骨与关节外科杂志,2017,10(4):271-279.
[12]李全,张源,梁跃伟,等.腰椎手术并发脑脊液漏的诊治进展.山东医药,2017,57(11):102-104.
[13]刘铁龙,严望军,袁文,等.胸腰椎内固定术后脊髓硬膜外血肿原因分析及其诊治.中华创伤杂志,2006,22(1):16-19.
[14]中华人民共和国卫生部.外科手术部位感染预防与控制技术指南(试行).北京:中华人民共和国卫生部,2010.23.
[15]中华医学会骨科学分会.预防骨科大手术深静脉血栓形成指南(草案).中国矫形外科杂志,2009,17(2):118-119.
[16]张志成,杜培,孟浩,等.后路短节段手术加速康复外科实施流程专家共识.中华骨与关节外科杂志,2019,12(6):401-409.
[17]孙浩林,越雷,王诗军,等.腰椎后路长节段手术加速康复外科实施流程专家共识.中华骨与关节外科杂志,2019,12(8):572-583.
[18]张馨予,宁宁,李佩芳,等.外科医护人员加速康复外科理念知信行现状及影响因素分析.中华现代理杂志,2016,22(33):4790-4795.
[19]陈信步,付红英,张永春,等.312名贵州省骨科护士加速康复外科认知的现状调查.骨科护理,2020,11(2):159-162.
[20]曾顾梅,欧才好,周丹,等.全员参与护理质量持续改进的实践及效果.当代护士(中旬刊),2019,26(4):178-180.
[21]赵靖,王笛,李菌,等.加速康复外科在医疗管理中的作用和意义.中国医院,2017,21(6):43-45.
[22]杨志强,曾建成,李涛,等.加速康复外科在OLIF结合前路内固定治疗腰椎管狭窄症合并退变性不稳中的应用.中国骨与关节杂志,2020,9(1):33-38.
[23]Strom RG, FrempongBoadu AK. Lowmolecularweight heparin prophylaxis 24 to 36 hours after degenerative spine surgery: risk of hemorrhage and venous thromboembolism. Spine,2013,38(23):E1498-E1502.
[24]Debono B, Corniola MV, Pietton R, et al. Benefits of enhanced recovery after surgery for fusion in degenerative spine surgery: impact on outcome, length of stay, and patient satisfaction. Neurosurg Focus,2019,46(4):E6.

备注/Memo

备注/Memo:
*通讯作者，Email:pangdong@bjmu.edu.cn①（北京大学护理学院，北京100191）①（北京大学第三医院骨科，北京100191）
更新日期/Last Update: 2021-05-11