Effect evaluation of perioperative nursing process optimization plus enhanced recovery after surgery for post-traumatic bone infection of lower limb / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical efficacy of optimizing perioperative nursing process and applying enhanced recovery after surgery (ERAS) model in the treatment of post-traumatic bone infection of lower limb using the membrane induction technique.Methods A retrospective case control study was conducted to analyze the clinical data of 225 patients with post-traumatic bone infection of lower limb admitted to the First Affiliated Hospital of Army Medical University from January 2015 to December 2016.There were 184 males and 41 females,aged 19-63 years,with an average age of 41.8 years.There were 123 patients with tibia infection,80 with femur infection and 22 with fibula infection.A total of 125 patients received process optimization plus ERAS (test group),and 100 patients received traditional treatment (control group).Visual analogue scale (VAS) before operation and 1,3 and 7 days after operation,incidence of deep venous thrombosis (DVT),bedridden time,sleep time,ambulation distance,length of stay in hospital and patient satisfaction were compared between the two groups.Results The VAS scores in the test group were (4.5 ± 0.7) points,(3.7 ± 0.6) points,and (2.7 ± 0.5) points at 1,3 and 7days after operation,which were lower than those in the control group (5.7 ± 0.8) points,(5.5 ± 0.8) points,(3.6 ± 0.5) points (P ＜ 0.05 or 0.01).There was no significant difference in VAS 10 days after operation between the two groups (P ＞ 0.05).The incidence of DVT in test group was 16.0％,which was significantly lower than that in the control group 39.0％ (P ＜ 0.01).The bedridden time of the test group was (3.5 ± 0.1) days,and that of the control group was (7.0 ± 0.4) days (P ＜0.05).The sleep time at 1,2,and 3 days after operation as well as the ambulation distance at 3,4,and 5 days after operation in the test group were significantly longer than those in the control group (P ＜0.05).The hospitalization time was (13.4 ± 1.2) days in the test group and (17.6 ± 1.9) days in the control group (P ＜ 0.05).The satisfaction rate was 99.2％ in the test group and 87.0％ in the control group (P ＜ 0.05).Conclusion During treatment of post-traumatic bone infection of lower limb using the membrane induction technique,nursing process optimization plus ERAS intervention program can effectively alleviate postoperative pain,improve daily activity abilities,shorten hospitalization time,improve patient satisfaction and better promote patient rehabilitation.