探讨快通道外科技术在综合外科围手术期中的应用

Discussion on Application of Operation Period of Fast Track Surgery in General Surgery

目的:探讨快通道外科技术在综合外科围手术期中应用的护理效果。方法:将192例患者分为对照组和观察组两组,对照组96例手术患者按常规护理;观察组96例手术患者应用快通道外科技术进行术前积极的心理护理、详细的健康教育和有效的交流,适当补充场内营养,不常规灌肠、不常规留置胃管尿管,缩短禁食、禁饮时间;术中严格控制输液量及盐水入量、充足吸氧、预防性应用抗生素、选择较好的手术方式最佳的麻醉方法及切口模式、合理调节室温并有效保暖、不常规放置腹部引流管;术后联合镇痛、早期肠内营养、尽早拔除腹部引流管尿管、早期功能锻炼和下床活动。结果:观察组96例手术患者在病情知晓率、护理配合程度、满意度调查方面较对照组明显提高,术后肛门排气排便时间较对照组提前,没有出现恶心呕吐、发热、误吸、肺部感染、静脉栓塞、切口感染等并发症,只有1例吻合口瘘,大大缩短了住院时间、降低了医疗费用。结论:应用快通道外科技术对手术患者进行围手术期护理,能更合理有效地控制患者的病理生理变化,减少了机体对手术所产生的应激和炎症反应,明显减少了并发症,加快了术后康复的速度,减轻了社会、医院及患者家庭的经济负担,值得推广。

Objective：To investigate the fast track surgery perioperative nursing application effect in operation period in general surgery.Method： 192 patients were divided into two groups,96 operation patients of control group were treatedby by usual care;96 operation patients with fast track surgery of the observation group were treated by positive psychological nursing,detailed health education and effective communication before operation, appropriate to add the nutrition,not routine enema,not routine indwelling gastric tube catheter,fasting,shorten drinking time;transfusion volume and the amount of sufficient oxygen,water,preventive application of antibiotic selection,operation way better optimal anesthesia method and incision model,reasonable adjust the room temperature and effective heat,no routine abdominal drainage tube placed strict control of surgery;postoperative analgesia,early enteral nutrition,early removal of abdominal drainage catheter tube,early functional exercise and activities.Result：96 cases operation patients of the observation group in the disease awareness,nursing,degree of satisfaction survey was obviously improved,early postoperative anus exhaust defecation time,no nausea and vomiting,fever aspiration,lung infection,venous thrombosis,infection of incisional wound,only 1 case of anastomotic fistula,shorten the hospitalization time,reduced the cost of medical care.Conclusion：The application of fast track surgery for operation period nursing on patients with operation,can be more reasonable and effective control of pathological and physiological changes of patients,reduces stress and inflammatory response of operation,complications,accelerated postoperative recovery rate,the society,hospital and the patients economic burden of the family,which is worthy of promotion.