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Journal of Nursing ›› 2020, Vol. 27 ›› Issue (2): 43-47.doi: 10.16460/j.issn1008-9969.2020.02.043

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Evidence-based Practice of Enhanced Recovery after Surgery for Patients with Hemorrhoids

GUO Su-yun1, DAI Ying2, SHI Lan-lai1, XI Run1, YAN Jing-ying1, YE Xiu-juan1   

  1. 1. Shenzhen Hospital of Beijing University of Chinese Medicine, Shenzhen 518172, China;
    2. Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
  • Received:2019-10-18 Published:2020-07-21

Abstract: Objective To explore and assess the effect of evidence-based enhanced recovery after surgery (ERAS) practice on postoperative rehabilitation of patients with hemorrhoids. Methods The standard procedure supported by the JBI-PACES program was used to retrieve relevant evidence of ERAS practice for postoperative rehabilitation of patients with hemorrhoids. JBI evidence pre-classification and evidence rank system (2014 edition) was used to evaluate the quality of evidence. FAME structure was used to evaluate the evidence from the respect of feasibility,appropriateness, clinical meaningfulness and effectiveness. The included evidence was translated into clinical audit indicators, and data were collected through reviewing nursing records, on-site examination and questionnaires. Comparisons were made in the effectiveness of treatment, anal pain, and incidence of complications before and after the implementation of the evidence-based ERAS practice. Results After the application of evidence, the effectiveness of treatment was improved (P<0.05) and patients' anal pain score on the first and fifth day after surgery was lower than that before the application of evidence (P<0.05). The incidence of postoperative complications after evidence application was lower than that before (P<0.05). Regarding the 11 indicators, the execution rate of all the indicators, except indicator 11, the execution rate of which had already been 100%, was higher after the application of evidence, indicating statistical significance(P<0.001). Conclusion Evidence-based nursing practice based on rapid rehabilitation surgery can optimize postoperative management of patients with hemorrhoids, improve therapeutic effect, reduce postoperative anal pain and the incidence of postoperative complications, and promote the rapid recovery of patients with hemorrhoids.

Key words: hemorrhoids, postoperative, rapid postoperative rehabilitation, nursing, evidence-based practice

CLC Number: 

  • R473.6
[1] Wren AA, Ross AC, D’Souza G, et al. Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids[J]. Children(Basel),2019,6(2):E33.DOI:10.3390/children 6020033.
[2] 肖景双. 肛肠病术后疼痛的机理及治疗[J].临床医药文献电子杂志,2018,5(52):68-69.DOI:10.3877/j.issn.2095-8242.2018.52.035.
[3] 沈洪明. 自拟痔篓熏洗剂坐浴治疗肛肠病术后疼痛水肿的观察[J].中医临床研究,2018,10(5):110-111.DOI:10.3969/j.issn.1674-7860.2018.05.051.
[4] 曾树宏,申璐,高月,等. 中医综合护理缓解肛肠疾病术后疼痛的系统评价[J]. 现代医药卫生,2018,34(1):27-28. DOI:10.3969/j.issn.1009?5519.2018.01.009.
[5] 张俊平,周英凤,周敏,等.提高与母乳喂养相关的乳头疼痛或损伤管理的循证实践[J].中华护理杂志, 2014, 49(9):1062-1066. DOI:10.3761/j.issn.0254-1769.2014.09.008.
[6] Davis BR, Lee-Kong SA, Migaly J, et al.The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids[J].Dis Colon Rectum,2018,61(3):284-292.DOI:10.1097/DCR.0000000000001030.
[7] 中华医学会外科学分会、中华医学会麻醉学分会.加速康复外科中国专家共识及路径管理指南(2018版)[J].中国实用外科指南,2018, 38(1):1-20.DOI:10.3969/j.issn.1674-9081.2018.06.002.
[8] Higuero T, Abramowitz L, Castinel A, et al.Guidelines for the Treatment of Hemorrhoids[J]. J Visc Surg, 2016, 153(3):213-218. DOI:10.1016/j.jviscsurg.2016.03.004.
[9] Glick DB, Holt NF, Nussmeier NA. Overview of Post-anesthetic Care Fore Adult Patients[EB/OL].(2018-10-22)[2019-05-24].https://www.uptodate.com/contents/overview-of-post-anesthetic-care-for-adult-patients?search=overview%20of%20postanesthetic%20care%20for%20adult%20patients&source=search_result&selectedTitle=1~150&usage_type= default&display_rank=1.
[10] Montgomery R, McNamara SA.Multimodal Pain Management for Enhanced Recovery:Reinforcing the Shift from Traditional Pathways Through Nurse-led Interventions[J]. AORN J, 2016,104(6S):S9-S16.DOI:10.1016/j.aorn.2016.10.012.
[11] 王春青,胡雁. JBI证据分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.DOI:10.16821/j.cnki.hsjx.2015.11.002.
[12] The Joanna Briggs Institute Levels of Evidence and Grades of Recommendation Working Party. Supporting Document for the Jonna Briggs Institute levels of Evidence and Grades of Recommendation[EB/OL]. (2014-03-01)[2018-08-29].http://joannabriggs.org/jbi-approach.html#tabbed-nav=Levels-of-Evidence
[13] 国家中医药管理局.中医病证诊断疗效标准(2012版)[S].北京:中国医药科技出版社,2012:112-124.
[14] 邓宝贵,全小明,谭彩霞,等. 电针配合耳穴压豆治疗人工髋置换患者术后疼痛效果观察[J].护理学报,2013,20(6B):58-59. DOI:10.3969/j.issn.1008-9969.2013.12.023.
[15] 邓颖辉,马冬花,姚秋琼,等. 激光坐浴对混合痔Milligan-Morgan术后患者伤口愈合的疗效观察[J].护理学报,2014,21(12):35-36.
[16] 梁健,谈燕飞,范元,等. 混合痔术后患者局部应用清热消炎洗剂湿热敷的效果观察[J]. 护理学报, 2011,18(4A):69-70. DOI:10.3969/j.issn.1008-9969.2011.07.023.
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