Abstract:

Objective: To analyze the effect of enhanced recovery after surgery (ERAS) concept in perioperative nursing of spinal tuberculosis. Methods: A total of 147 patients with spinal tuberculosis treated in the Department of Surgical of Qingdao Chest Hospital from July 2017 to June 2020 were collected. Of them, 68 cases treated from July 2017 to December 2018 received routine nursing during the perioperative period (control group); 79 cases from January 2019 to June 2020 who underwent surgery were treated with the ERAS concept on the basis of routine nursing measures (ERAS group). The time of drainage tube extraction, first getting out of bed for functional exercise and initial spontaneous urination, pain score 72 hours after operation (using visual analog scoring (VAS) method), the length of hospital stay, the incidence of nausea and vomiting, the incidence of lung infection and drug-induced liver damage, and the patient's satisfaction were observed and compared between the two groups. Results: Compared with the control group, the drainage tube removal time, the initial time to get out of bed for functional exercise, the initial spontaneous urination time, VAS score 72 h after operation and the length of hospital stay in the observation group were all significantly shorter than those in the control group (6.00(4.00,8.00) d vs. 8.00 (7.00,8.00) d, W=4321.000, P<0.001; 2.00 (2.00,4.00) d vs. 5.50 (4.25,6.00) d, W=3376.000, P<0.001; 5.00 (3.00, 6.00) h vs. 9.00 (7.00, 9.00) h, W=3369.000, P<0.001; 3.00 (2.00, 4.00) vs. 5.00 (5.00, 6.00), W=4078.500, P<0.001; 19.00 (18.00, 21.00) d vs. 22.00(19.00,27.00) d, W=4791.500,P<0.001, respectively). The incidences of postoperative nausea and vomiting and pulmonary infection, and drug-induced liver damage in the observation group were significantly lower than those in the control group (7.6% (6/79) vs. 19.1% (13/68), χ²=4.311,P=0.038; 2.5% (2/79) vs. 11.8% (8/68), χ²=4.914, P=0.027; and 1.3% (1/79) vs. 13.2% (9/68), χ²=8.258, P=0.004, respectively). The patient satisfaction in the observation group was significantly higher than that in the control group (96.2% (76/79) vs. 85.3% (58/68), χ²=7.100, P=0.008). Conclusion: The application of ERAS concept in perioperative nursing of spinal tuberculosis can speed up the recovery, reduce the occurrence of complications, and improve the satisfaction.

Key words: Perioperative care, Rehabilitation, Tuberculosis,spinal, Comparative study