目前,没有基于ERAS概念的RARC围手术期护理标准。这项回顾性研究旨在分析RARC-ERAS护理计划对接受RARC手术的患者的VTE和其他临床结局的影响。这项回顾性研究包括2022年1月1日至2023年12月30日接受RARC手术的216例患者,并应用倾向评分调整分析。该研究比较了接受传统护理的对照组和接受RARC-ERAS护理程序的观察组。从医院医疗记录中检索围手术期变量和其他术后并发症。在倾向得分匹配后,两组患者的人口统计学和临床特征差异无统计学意义(p>0.05)。通过彩色多普勒超声检查,ERAS组术后下肢静脉血流通畅率明显高于对照组(94.6%VS80.4%,p=0.042)。麻醉诱导前,ERAS组术前焦虑和手术信息需求评分低于对照组(p<0.05)。与对照组相比,ERAS组的手术时间较短,围手术期体温过低的发生率较低,起床所需的时间更少,肛门排气,返回病房后排便(p<0.05)。RARC-ERAS护理方案显著提高了术后下肢静脉血流通畅率,RARC患者术前焦虑和术中低体温。这种护理方法为提高患者预后提供了有价值的策略,值得在临床实践中进一步探索。试用登记:ChiCTR2400081118;http://www.chictr.org.cn,首席调查员:何芒满,注册日期:2024年2月22日。
Currently, there is no specific perioperative nursing standard for RARC based on the ERAS concept. This retrospective study investigates to analyze the effect of RARC-ERAS nursing program on VTE and other clinical outcomes in patients undergoing RARC surgery. This retrospective study included 216 patients undergoing RARC surgery From January 1, 2022 to December 30, 2023, and propensity score adjustment analysis was applied. The study compares a control group receiving traditional nursing and an observation group receiving RARC-ERAS nursing program. Perioperative variables and other postoperative complications were retrieved from the hospital medical records. After propensity score matching, there were no significant differences in the demographic and clinical characteristics between the two groups (p > 0.05). The ERAS group exhibited aa significantly higher rate of postoperative unobstructed venous blood flow in the lower extremities by color Doppler ultrasound as compared to the control group (94.6% VS 80.4%, p = 0.042). Before anesthesia induction, lower preoperative anxiety and surgical information needs scores were observed in the ERAS group than in the control group (p < 0.05). Compared to the control group, the ERAS group demonstrated a shorter surgical duration, a lower incidence of perioperative hypothermia, less time needed for getting out of bed, anal exhaust, and for defecation after returning to the ward (p < 0.05). RARC-ERAS nursing program significantly increased the rate of postoperative unobstructed venous blood flow in the lower extremities by color doppler ultrasound, lower preoperative anxiety and intraoperative hypothermia in patients undergoing RARC. This nursing approach presents a valuable strategy for enhancing patient outcomes and merits further exploration in clinical practice.Trial registration:ChiCTR2400081118; http://www.chictr.org.cn , Principal investigator: Mang-mang He, Date of registration: Feb 22, 2024.