Li Yuxuan,Zhang Hanwen,Wei Nan,et al.Application of a process-based communication model plus a concept of accelerated recovery after surgery in children undergoing congenital spinal malformation surgery:one case-control study[J].Journal of Clinical Pediatric Surgery,,():267-272.[doi:10.3760/cma.j.cn101785-202307058-013]
Application of a process-based communication model plus a concept of accelerated recovery after surgery in children undergoing congenital spinal malformation surgery:one case-control study
- Abstract:
- Objective Exploring the perioperative application effect of a process based communication model combined with the concept of accelerated recovery after surgery (ERAS) in children with congenital spinal deformities (CS),and summarizing clinical experience.Methods This study is a prospective study.A total of 68 pediatric patients with CS who underwent surgical treatment in our hospital from February 2022 to February 2023 were selected as the study subjects.They were divided into a study group (n=34) and a control group (n=34) based on management mode.The control group adopted a simple ERAS perioperative management model,while the research group adopted a procedural communication model combined with ERAS philosophy for perioperative intervention.Compared the time of first postoperative discharge,wound healing time,average hospital stay,Chinese version of the screening chart (screen for child anxiety related emotional disorders,SCARED) Score,Chinese version of children Depression Disorder scale (depression self-rating scale for children,DSRSC) differences in scores,treatment adherence scores,number of ERAS measures completed,complication rate,and pain scores.Results Among all patients,27 were male and 41 female,mean age (8.31±3.79) years,and there was no significant difference between the baseline data of the two groups (P>0.05).The postoperative time of first discharge and wound healing time in the study group were (32.76±5.57) h and (8.41±1.65) d,significantly earlier than the control group (62.94±7.81) h and (9.56±2.60) d (first discharge time t=18.345,P<0.001;wound healing time t=2.173,P=0.033).The mean hospital day of stay in the study group was (11.12±2.14) d,significantly shorter than d (15.18±2.48) in the control group (t=7.221,P<0.001).Tthe two groups’ admission SCARED score[Study group (20.65±2.01) vs.Control group (20.18±2.17),t=0.928,P=0.357] and DSRSC score (study group (12.59±2.12) vs.control group (12.68±2.07),t=0.174,P=0.863］ not significant (P greater than 0.05).However,the SCARED and DSRSC scores of the study group were (12.35±2.10) and (9.88±1.70),significant lower (18.59±1.79) and (11.09±1.85) points than the control group,The differences were statistically significant (P was less than 0.05);[Study group (13.76±1.44) vs. control group (9.32±1.84),t=11.102,P<0.001],number of items completed by ERAS measures [Study group (15.91±1.49) vs. Control group (13.35±1.54),t=6.987,P<0.001],complication rate (5.88% of the study group vs. 23.53 of the control group,χ2= 4.221,P=0.040) and pain score [study group (2.91±0.87) vs.control group (3.76±1.39),t=3.031,P=0.003] were all superior over the control group.Conclusions The application of a procedural communication model combined with ERAS concept in perioperative management of CS patients has a better effect,which can effectively improve the postoperative rehabilitation level and treatment compliance of patients,reduce their psychological stress level,and reduce the incidence of complications.
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Memo
收稿日期:2023-7-24。
基金项目:深圳市“医疗卫生三名工程”项目 (SZSM202011012)
通讯作者:张凤云,Email:zhangfengyun@163.com