Application Research of Perioperative Clinical Pathway Based on Accelerated Rehabilitation Surgery Strategy in Patients with ERCP

Abstract

Objective: To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography (ERCP). Methods: Randomly selected 40 patients undergoing ERCP from our hospital which is People’s Hospital, Jingjiang City, for research, and divided the patients into two groups. The 20 patients who were given conventional education methods were set as the reference group, and the 20 patients who were given perioperative clinical pathway care with accelerated rehabilitation surgery strategies were the research group, where the clinical nursing effect of the two groups was statistically compared. Results: According to clinical observation and statistics, the study group’s postoperative time to eat for the first time, time to get out of bed, hospitalization time, and surgical blood loss were better than those of the reference group, P<0.05; the anxiety and depression scores of the study group were lower than those after nursing in the reference group, P<0.05; the incidence of complications in the study group was lower than that in the reference group, and patient satisfaction was higher than that in the reference group, where both P<0.05. Conclusion: The application of perioperative clinical pathway care based on the strategy of accelerated rehabilitation surgery can achieve significant results in ERCP patients, which can effectively improve the surgical indicators of patients and reduce the risk of complications.

The application of enhanced recovery after surgery (ERAS) in chronic rhinosinusitis patients undergoing endoscopic sinus surgery: A systematic review and meta-analysis

“…All 28 RCTs enrolled in this meta-analysis involved 2636 CRS patients (1321 in the ERAS group and 1315 in the SC group). 24 studies [ 21 – 24 , 26 – 28 , 30 – 46 ] recruited both CRSwNP and CRSsNP patients, and the other four studies [ 5 , 16 , 25 , 29 ] only focused on the patients with CRSwNP. ERAS elements adopted by these studies ranged from 6 to 14.…”

“…ERAS elements adopted by these studies ranged from 6 to 14. In terms of the research contents, ten studies [ 16 , 21 – 29 ] had reported LOS, 13 studies [ 5 , 16 , 21 , 23 , 24 , 26 , 28 – 34 ] had outcomes on the incidence of overall postoperative complication, nine studies [ 5 , 16 , 23 , 29 , 30 , 32 , 35 – 37 ] reported PONV, eight studies [ 24 , 26 , 30 , 32 , 33 , 35 – 37 ] on facial edema, seven studies [ 24 , 26 , 32 , 33 , 35 – 37 ] on low back pain and urinary retention, five studies [ 21 , 23 , 29 – 31 ] on haemorrhage, 12 studies reported [ 21 , 23 , 24 , 26 , 27 , 30 – 32 , 38 – 41 ] VAS pain scores, seven studies [ 30 , 31 , 34 , 42 , 43 , 45 ,…”

“…Thirteen studies (a total of 1274 patients) [ 5 , 16 , 21 , 23 , 24 , 26 , 28 – 34 ] reported overall postoperative complications. Specifically, 9 studies [ 5 , 16 , 23 , 29 , 30 , 32 , 35 – 37 ] reported PONV (involving 926 CRS patients), 8 studies [ 24 , 26 , 30 , 32 , 33 , 35 – 37 ] for facial edema (involving 688 CRS patients), 7 studies [ 24 , 26 , 32 , 33 , 35 – 37 ] for low back pain and urinary retention (involving 568 CRS patients), and 5 studies [ 21 , 23 , 29 – 31 ] for haemorrhage (involving 630 CRS patients).…”

“…Descriptive analyses were also performed in this study to supplement the outcomes for which quantitative meta-analysis was not successful. Among the included studies, ten studies [ 5 , 28 , 31 , 33 , 37 , 39 , 41 – 44 ] reported patients’ QOL from different evaluation criteria. We were unable to combine the data due to opposite evaluation criteria, so descriptive analysis was used.…”

“…Three studies [ 37 , 41 , 44 ] used the GQOL-74 scale, four studies [ 31 , 33 , 39 , 42 ] used a homemade life scale, and one study [ 43 ] used the EORTC core quality of life questionnaire (QLQ-C30) scale, and all eight studies yielded significantly higher QOL scores in the postoperative ERAS versus SC group ( P < 0.05), reflecting the improved QOL of postoperative patients in the ERAS group and the effectiveness of the comprehensive nursing measures for rehabilitation. In addition to this, two other studies [ 5 , 28 ] used a QOL scale that was positively correlated with disease severity, with higher scores being associated with poorer quality of life and more severe disease. In one study [ 28 ], patients’ QOL was evaluated using the SNOT-20 scale, and it was observed that the QOL scores of CRS patients of the ERAS group were markedly reduced compared to the SC group after surgery ( P < 0.05), which reflected a meaningful enhancement in the QOL of the patients.…”