Analysis of the effect of nausea and vomiting nursing for patients undergoing cholecystectomy based on the CM-ERAS concept
基于CM-ERAS理念的胆囊切除术患者恶心呕吐护理的效果分析

摘要

目的 探讨基于中医药加速康复外科（CM-ERAS）理念实施恶心呕吐护理对胆囊切除术患者的应用价值。方法 选取本院2023年5月至2024年9月收治的84例胆囊切除术患者，根据奇偶数法随机分组，对照组（常规护理，42例），观察组（基于CM-ERAS理念的恶心呕吐护理方案，42例）。对比两组术后0-6、7-12、13-18、19-24h的术后恶心呕吐（PONV）发生率，对比两组术后胃肠道功能恢复相关指标（首次排气、首次进食、肠鸣音恢复），并对比两组术后并发症（腹胀、腹泻、胆汁反流）发生风险。结果 术后0-6、7-12、13-18、19-24h观察组的PONV发生率均低于对照组，且术后首次排气、进食、肠鸣音恢复用时均短于对照组，术后并发症总发生率更低（P＜0.05）。结论 对胆囊切除术患者实施基于CM-ERAS理念的恶心呕吐护理能显著缓解其术后恶心呕吐感，促进其胃肠道功能恢复，并预防并发症，值得临床推广。

Abstract

Objective To explore the application value of nausea and vomiting nursing based on the concept of Enhanced Recovery after Surgery (CM-ERAS) of traditional Chinese medicine in patients undergoing cholecystectomy.
Methods A total of 84 patients who underwent cholecystectomy and were admitted to our hospital from May 2023 to September 2024 were selected and randomly grouped according to the odd-even number method. The control group (conventional care, 42 cases) and the observation group (nausea and vomiting nursing plan based on the CM-ERAS concept, 42 cases). Compare the incidence of postoperative nausea and vomiting (PONV) between two groups at 0-6, 7-12, 13-18, and 19-24 hours after surgery, compare the relevant indicators of gastrointestinal function recovery (first exhaust, first food intake, bowel sounds recovery) between the two groups, and compare the risk of postoperative complications (abdominal distension, diarrhea, bile reflux) between the two groups.
Results The incidence of PONV in the observation group was lower than that in the control group at 0-6, 7-12, 13-18, and 19-24 hours after surgery, and the recovery time of the first exhaust, eating, and bowel sounds after surgery was shorter than that in the control group. The overall incidence of postoperative complications was also lower (P < 0.05).
Conclusion   Implementing nausea and vomiting care based on the CM-ERAS concept for patients undergoing cholecystectomy can significantly alleviate their postoperative nausea and vomiting, promote the recovery of gastrointestinal function, and prevent complications. It is worthy of clinical promotion.