流程化沟通模式结合加速康复外科理念在先天性脊柱畸形手术患儿中应用的病例对照研究OA北大核心CSTPCD

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 spi-nal deformities(CS),and summarizing clinical experience.Methods This study is a prospective study.A to-tal of 68 pediatric patients with CS who underwent surgical treatment in our hospital from February 2022 to Feb-ruary 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 manage-ment model,while the research group adopted a procedural communication model combined with ERAS philoso-phy for perioperative intervention.Compared the time of first postoperative discharge,wound healing time,aver-age 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 chil-dren,DSRSC)differences in scores,treatment adherence scores,number of ERAS measures completed,compli-cation 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,X2=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.