早期下床活动对后腹腔镜下肾上腺肿瘤切除术患者快速康复的效果

Effect on early ambulation for rapidly recovery in patients undergoing retroperitoneal laparoscopic adrenalectomy

目的探索和实践早期下床活动护理模式对后腹腔镜下肾上腺肿瘤切除术患者快速康复的影响。方法将2013年6月—2014年6月120例行后腹腔镜下肾上腺肿瘤切除术的患者作为研究对象，根据计算机随机函数法将患者分为对照组和干预组。对照组采用常规围术期护理，干预组按照早期下床活动护理模式进行干预。记录患者下床活动时间、患者疼痛程度、首次进食时间、输液时间、术后住院时间、住院费用和并发症的情况。结果干预组患者平均下床时间为（10．8±5．1）h，短于对照组的（28．2±12．0）h，差异有统计学意义（t=10．100，P〈0．01）。干预组患者术后24hVAS评分为（0．9±1．0）分，对照组为（1．7±1．2）分，差异有统计学意义（t=4．032，P〈0．01）。术后干预组患者首次进食时间、输液时间、术后住院时间、治疗费用分别为（8．4±3．7）h，（2．5±1．1）d，（3．2±1．6）d，（2．0±0．5）万元，均优于对照组，差异有统计学意义（￡值分别为14．260，5．373，4．815，4．033；P〈0．01）。干预组患者并发症的发生率为5．3％，低于对照组的18．6％，差异有统计学意义（X2=4．891，P〈0．05）。结论对腹腔镜下肾上腺肿瘤切除术患者进行早期下床活动的护理干预可以促进患者快速康复。

Objective To investigate the effects on early ambulation for rapid recovery in patients undergoing retroperitoneal laparoscopic adrenalectomy. Methods From June 2013 to June 2014, 120 cases underwent retroperitoneal laparoscopic adrenalectomy were randomly divided into the control group and the experimental group. The patients in the control group were taken conventional preoperative cares. Meanwhile, early ambulation interventions were given to the experimental group. Time for early ambulation, first eating and venous transfusion, postoperative hospital stays, hospitalization costs and complications were evaluated. Results The mean time of postoperative ambulation in the experimental group was （ 10.8 ~ 5.1 ） hours, which was significantly higher than that of the control group （28.2 ~ 12.0）hours, （ t = 10. 100,P 〈 0.01 ）. After 24 hours of the operation, score of VAS in the experimental group was （0.9 ± 1.0） , whieh was significantly lower than that of the control group （ 1.7±1.2）, （ t = 4. 032, P 〈 0.01 ）. The eating time, transfusion time, postoperative hospital stays and hospitalization costs of the experimental group were （ 8.4 ± 3.7 ） hours, （2.5 ± 1.1 ） days, （3.2 ±1.6） days and （ 20 000 ± 5 000 ） RMB, which were significantly better than those of the control group （t =14.260, 5. 373, 4. 815, 4. 033, respectively;P 〈0.01 ）. The rate of complication in the experimental group was 5.3% , which was significantly lower than that of the control group（ 18.6% ） , （ X2 = 4. 891, P 〈 0.05 ）. Concclusions Nursing interventions with early ambulation model in patients undergoing retroperitoneal laparoscopic adrenaleetomy can reduce postoperative hospital stays, hospitalization costs and eventually promote rapid recovery.