加速康复外科理念护理对胆囊结石合并肝外胆管结石患者术后康复进程及并发症的影响

Effect of Enhanced Recovery After Surgery Concept Nursing on the Postoperative Rehabilitation Process and Complications of Patients with Cholecystolithiasis Combined with Extrahepatic Bile Duct Stones

目的探讨加速康复外科(ERAS)理念护理对胆囊结石合并肝外胆管结石患者术后康复进程及并发症的影响.方法选取本院2019年5月—2022年6月收治的78例胆囊结石合并肝外胆管结石患者,按随机数字表法分为对照组(n=39)、观察组(n=39).对照组采用常规护理,观察组采用ERAS理念护理,均护理至出院.比较两组的康复进程、疼痛视觉模拟评分(VAS)、并发症发生情况及满意度.结果观察组的肛门排气时间、初次进食时间、初次下床时间、引流管拔除时间、住院时间分别为(27.72±4.35)h、(26.36±2.17)h、(13.76±2.52)h、(29.64±5.22)h、(5.75±0.63)d,均短于对照组的(39.36±5.71)h、(48.59±7.24)h、(24.48±5.87)h、(57.38±6.19)h、(7.84±0.69)d,组间差异有统计学意义(P<0.05).观察组术后4、12、24 h的VAS评分均低于对照组,组间差异有统计学意义(P<0.05).观察组的并发症发生率为10.26%,低于对照组的30.77%,总满意度为97.44%,高于对照组的79.49%,组间差异有统计学意义(P<0.05).结论ERAS理念护理能加快胆囊结石合并肝外胆管结石患者的术后康复进程,降低并发症发生率,减轻术后疼痛,提升患者满意度.

Objective To explore the effect of enhanced recovery after surgery(ERAS)concept nursing on the postoperative rehabilitation process and complications of patients with cholecystolithiasis and extrahepatic bile duct stones.Methods 78 patients with cholecystolithiasis combined with extrahepatic bile duct stones admitted to the hospital from May 2019 to June 2022 were selected and were divided into a control group(n=39)and an observation group(n=39)according to random number table method.The control group was treated with conventional nursing,while the observation group was treated with ERAS concept nursing.Both groups were nursed until discharge.The recovery progress,pain visual analogue scale(VAS)score,complications and satisfaction of the two groups were compared.Results The time of anal exhaust,the time of first feeding,the time of first getting out of bed,the time of drainage tube removal and the time of hospitalization in the observation group were(27.72±4.35)h,(26.36±2.17)h,(13.76±2.52)h,(29.64±5.22)h,(5.75±0.63)d,respectively,which were shorter than(39.36±5.71)h,(48.59±7.24)h,(24.48±5.87)h,(57.38±6.19)h,(7.84±0.69)d in the control group,and the differences between the groups were statistically significant(P<0.05).The VAS scores of the observation group at 4,12 and 24 h after surgery were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 10.26%,which was lower than 30.77%in the control group,and the total satisfaction was 97.44%,which was higher than 79.49%in the control group,the differences between the groups were statistically significant(P<0.05).Conclusion ERAS concept nursing can accelerate the postoperative rehabilitation of patients with cholecystolithiasis complicated with extrahepatic bile duct stones,reduce the incidence of complications,relieve postoperative pain and improve patient satisfaction.