中国医药指南

目的 分析营养风险筛查2002量表（NRS2002）结合加速康复外科理念-多学科协同诊疗（ERAS-MDT）模式的护理干预对肝切除患者术后营养指标及视觉模拟量表（VAS）评分的影响。方法 将2021年10月至2022年10月接收的320例肝切除患者纳入研究，随机分为试验组与参照组，每组160例。参照组给予普通护理干预，试验组给予NRS2002结合ERAS-MDT模式的护理干预，对比两组术后第1天、术后第3天、出院日的营养指标（血清转铁蛋白、白蛋白、前白蛋白）水平、VAS评分、不良反应发生率与护理满意率。结果 术后第1天，两组患者的营养指标水平、VAS评分无统计学意义（P> 0.05）；术后第3天、出院日，两组患者的营养指标水平均提高，试验组高于参照组（P <0.05），两组患者的VAS评分均下降，试验组低于参照组（P <0.05）；试验组的不良反应发生率低于参照组，护理总满意率高于参照组（P <0.05）。结论 NRS2002结合ERAS-MDT模式的护理干预对肝切除患者术后营养指标及VAS评分有积极影响，一方面可显著改善患者的营养状态，另一方面可减轻疼痛，从而促进身体恢复。

Objective To analyze the effects of Nutritional Risk Screening 2002 Scale(NRS2002) combined with accelerated rehabilitation surgery concept and multidisciplinary collaborative treatment(ERAS-MDT) model on postoperative nutritional indexes and visual analog scale(VAS) scores in patients with hepatectomy. Methods A total of 320 hepatectomy patients received from October 2021 to October 2022 were included in the study and randomly divided into experimental group and reference group, with 160 cases in each group. The reference group was given general nursing intervention, and the experimental group was given NRS2002 combined with ERAS-MDT mode of nursing intervention. The levels of nutritional indexes(serum transferrin, albumin and prealbumin), VAS score, adverse reaction incidence rate and nursing satisfaction rate of the two groups were compared on the first day after surgery, the third day after surgery and the day of discharge. Results On the first day after surgery, there was no statistical significance in the level of nutritional indexes and VAS scores between the two groups(P>0.05). On the third day after surgery and on the day of discharge, the nutritional indexes of both groups were increased, the experimental group was higher than the reference group(P<0.05),the VAS scores of both groups were decreased, and the experimental group was lower than the reference group(P<0.05). The adverse reaction incidence rate of the experimental group was lower than that of the reference group, and the nursing satisfaction rate was higher than that of the reference group(P<0.05). Conclusions Nursing intervention of NRS2002 combined with ERAS-MDT model had positive effects on postoperative nutritional indexes and VAS scores of patients with hepatectomy, which significantly improved nutritional status on the one hand and alleviated pain on the other hand, thus promoting physical recovery.