综合护理模式对阑尾炎术后护理的最佳证据总结

胡晨阳; 张睿哲

doi:10.70693/cjmsr.v1i2.1346

Authors

胡晨阳杭州师范大学
张睿哲杭州师范大学

DOI:

https://doi.org/10.70693/cjmsr.v1i2.1346

Keywords:

阑尾切除术；术后护理；综合护理模式；加速康复外科（ERAS）；循证护理

Abstract

系统评价综合护理模式（CNM）在阑尾炎术后护理中的应用效果，总结其核心措施、效果、不同手术方式下的护理要点、实施障碍与对策等最佳证据。根据系统检索中英文数据库（PubMed, Embase, Cochrane Library, Web of Science, CNKI,CINAHL），纳入关于阑尾切除术（开放或腹腔镜）患者应用综合护理模式（强调多学科协作、循证、个体化、覆盖围手术期）的随机对照试验（RCT）、队列研究、系统评价/Meta分析及临床指南。得出综合护理模式可有效改善阑尾炎术后康复质量，其成功实施需结合手术方式和机构特点个体化应用。基于本研究构建的包含12个条目的三维质量评价体系进行监测与优化，并着力提升领导支持与信息化水平，是推动该模式落地的关键。

References

[1] Sartelli M, et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11:34.

[2] Ljungqvist O, et al. Enhanced Recovery After Surgery (ERAS) Society recommendations for gynecologic oncology. Int J Gynecol Cancer. 2021;31(1).

[3] Gustafsson UO, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg. 2019;43(3):659-695.

[4] Lee SM, et al. Variations in implementation of Enhanced Recovery After Surgery (ERAS) and outcomes in appendectomy. Am J Surg. 2020;220(1): 54-59.

[5] Smith I, et al. Multimodal approaches to postoperative recovery. Curr Opin Crit Care. 2019;25(6):688-693.

[6] Gillis C, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;121(5):937-947.

[7] Madrid E, et al. Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database Syst Rev. 2016;4:CD009016.

[8] Rollins KE, et al. The impact of perioperative fluid therapy on short-term outcomes in laparoscopic appendectomy. Surg Laparosc Endosc Percutan Tech. 2018;28(1):42-46.

[9] Joshi GP, et al. Evidence-based postoperative pain management after laparoscopic abdominal surgery. Colorectal Dis. 2017;19(9):783-791.

[10] Varadhan KK, et al. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010;29(4):434-440. (Meta分析/早期营养)

[11] Liu Z, et al. Probiotics in preventing postoperative infection in patients with perforated appendicitis: a systematic review and meta-analysis. Int J Colorectal Dis. 2021;36(8): 1687-1695.

[12] Lawrence VA, et al. Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006;144(8):596-608.

[13] Powell R, et al. Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database Syst Rev. 2016;5:CD008646.

[14] Pedziwiatr M, et al. Enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic appendectomy. Videosurgery Miniinv. 2016;11(3): 177-182.

[15] Gan TJ, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020;131(2):411-448.

[16] Li P, et al. Comparison of outcomes following laparoscopic versus open appendectomy for acute appendicitis: a retrospective cohort study. Int J Surg. 2020;83: 35-40.

[17] Dumville JC, et al. Dressings for the prevention of surgical site infection. Cochrane Database Syst Rev. 2016;12:CD003091.

[18] Miskovic A, et al. Systematic review of respiratory physiotherapy after thoracic and upper abdominal surgery. Br J Surg. 2008;95(1):17-27.

[19] Di Saverio S, et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11:34.

[20]占斌容,郑少英,刘巧燕.分析基于ERAS理念的综合护理干预对腹腔镜阑尾炎切除术后患者恢复速度、疼痛感受及睡眠质量的影响[J].世界睡眠医学杂志,2024,11(11):2570-2572+2576. (示例过程指标提升)

[21]郭立梅.基于ERAS的综合护理方案对阑尾炎老年患者急诊手术术后并发症的影响分析[J].中外医疗,2024,43(33):141-145.

[22]李小云.围术期综合护理对急性阑尾炎合并高血压患者的影响分析[J].中西医结合心血管病电子杂志,2023,11(23):8-11.

[23]汤艮双.围手术期综合护理在急性阑尾炎合并高血压患者中的应用效果分析[J].中西医结合心血管病电子杂志,2023,11(05):68-71.

[24]陈金者.围术期综合护理对急性阑尾炎合并高血压患者住院时间及血压水平的影响[J].心血管病防治知识,2022,12(19):48-51.

[25]沈燕兰,罗秀华,刘悠,等.围手术期综合护理干预对阑尾炎患者术后恢复效果及生活质量的影响[J].基层医学论坛,2024,28(17):104-107.

[26]张淑琴.综合护理干预在急性化脓性阑尾炎手术治疗中的护理效果及对依从性的影响研究[J].现代诊断与治疗,2023,34(17):2670-2673.

[27]王静雅,陈新胜,吕宛颖.综合护理在经脐单孔腹腔镜治疗急性阑尾炎中的应用[J].保健医学研究与实践,2022,19(06):89-91.

[28]周艳.化脓性阑尾炎腹腔镜切除术行综合护理的临床效果分析[J].中国医药指南,2021,19(28):16-18.