RESUMO
Objective:To explore the effects of Xiao's double-C nursing mode based on enhanced recovery after surgery (ERAS) on perioperative related indexes and pain in patients undergoing mixed hemorrhoid surgery.Methods:From August 2019 to August 2020, 60 patients undergoing mixed hemorrhoid surgery who were admitted to anorectal surgery department of Anqing Municipal Hospital were enrolled as the research objects by single center, random, single blind and parallel control methods. They were divided into control group (routine perioperative nursing) and observation group (ERAS-based Xiao's double-C nursing mode) by random number table method, 30 cases in each group. The perioperative indexes, scores of postoperative Visual Analogue Scale (VAS) and wound healing, postoperative complications and nursing satisfaction were compared between the two groups.Results:The first urination time, defecation time, hospitalization time and hospitalization cost were (5.78±1.38) h, (13.37±2.38) h, (7.32±0.72) d and (7 337.84±524.99) yuan in the observation group, and (6.48±1.26) h, (16.72±2.33) h, (8.85±0.93) d, (8 689.54±688.34) yuan in the control group, and the differences were statistically significant ( t values were 2.052-8.552, P<0.01 or 0.05). There were between-group, time and interaction differences in the scores of VAS and postoperative wound healing between the two groups ( Fbetween-group values were 36.24, 42.36, Ftime values were 256.71, 377.42, Finteraction values were 88.62,90.62, P<0.01). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). The scores of nursing satisfaction with health education and services accessibility were (94.37±2.92), (95.11±3.85) points in the observation group, and (92.38±3.01), (91.72±4.31) points in the control group, and the differences were statistically significant ( t values were 2.599, 3.213, P<0.05). Conclusions:ERAS-based Xiao's double-C nursing mode is beneficial to shorten first defecation time, incision healing time and hospitalization time of patients undergoing mixed hemorrhoid surgery, accelerate wound healing and alleviate pain, with higher nursing satisfaction.
RESUMO
Objective:To explore the effect of artificial dermis combined with autogenous thin skin graft on the survival rate of compound skin graft and the scar state of joints in burn patients.Methods:94 burned patients treated in Baoding Fifth Hospital from August 2017 to August 2019 were prospectively selected as the research objects. They were randomly divided into two groups with 47 cases in each group. The control group was treated with simple medium thick skin transplantation, and the observation group was treated with artificial dermis combined with autologous thin skin grafting. The recovery of the two groups (healing time of skin donor area, healing time of skin graft area, healing time under scab of burn area and hospitalization time) were compared. The survival rate of composite skin transplantation, wound healing, Vancouver Scar Scale (VSS) score, joint range of motion (shoulder abduction, knee flexion, knee extension), Burn Specific Health Scale-Brief (BSHS-B), Profile of Mood States-Short Form (POMS-SF) score and complications were compared.Results:The healing time of donor area, skin graft area, subeschar healing time and hospital stay in the observation group were shorter than those in the control group ( P<0.05). The wound healing in the observation group was better than that in the control group, and the survival rate of composite skin transplantation was higher than that in the control group ( P<0.05). After treatment, the scar state of the joint in the two groups was improved compared with that before treatment ( P<0.05); The scar thickness, vascular distribution score and total score of VSS in the observation group were lower than those in the control group ( P<0.05). After treatment, the joint range of motion in the two groups was improved compared with that before treatment ( P<0.05); The shoulder abduction, knee flexion and knee extension in the observation group were higher than those in the control group ( P<0.05). After treatment, the quality of life and psychological status of the two groups were improved compared with those before treatment ( P<0.05); The BSHS-B score of the observation group was higher than that of the control group, and the POMS-SF score was lower than that of the control group ( P<0.05); The incidence of complications in the observation group (4.26%) was lower than that in the control group (21.28%) ( P<0.05). Conclusions:Artificial dermis combined with autologous thin skin graft can significantly improve the survival rate of compound skin graft in burned patients, and can further reduce the scar condition of the joints of patients, reduce the incidence of complications, and effectively improve the prognosis of patients.