腹腔镜胆囊切除术后早期随意体位的安全性研究

Arbitrary position in the early period after laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术后指导患者早期随意体位的可行性及安全性。方法将186例腹腔镜胆囊切除术后患者随机分为观察组和对照组，观察组94例患者指导术后2h开始随意活动四肢；对照组92例患者术后予以常规腹腔镜术后护理，比较两组术后腹胀、疼痛和尿潴留发生率。结果观察组发生腹胀4例，尿潴留3例，腰肌酸痛15例；对照组发生腹胀13例，尿潴留12例，腰肌酸痛60例，组间比较差异具有统计学意义（X2=5．460，6．087，46．885；P〈0．05）。结论腹腔镜胆囊切除术后2h指导患者随意体位安全可行，可减少患者腹胀、腰肌酸痛和尿潴留，不加重患者活动后疼痛、头晕、心慌和乏力，有利于患者早日康复。

Objective To evaluate the feasibility and safety of taking arbitrary position in the early period after laparoscopic cholecystectomy. Methods 186 patients who underwent laparoscopic cholecystectomy from Jun. 2010 to Oct. 2010 were randomly divided into two groups, observation group （n = 94） and control group （ n = 92） ; the former group was instructed to freely mobilize 2 hours after the operation, while the latter group was administered with traditional nursing. Abdominal distension, pain, urinary retention of both groups after laparoscopic cholecystectomy were compared. Results The observation group happen abdominal distension 4 cases ,urinary retertion in 3, lumbar muscle ache 15 cases and control group happen abdominal distension 13 cases,urinary retention in 12 cases, lumbar mascle ache 60 cases, and muscle soreness after laparoscopic cholecystectomy were obviously lower in the observation group, and the differences between both groups were statistically significant （ x2 = 5. 460, 6.087, 46.885 ; P 〈 0. 05 ）. Conclusions Taking arbitrary position in the early period 2 hours after laparoscopic cholecystectomy is safe and feasible, it can also reduce the occurrence of abdominal distension, urinary retention and muscle soreness, mitigate pain, dizzy, palpitation and lack of energy, and facilitate patients＇ early recovery.