中西医结合护理在腹腔镜胆囊摘除术患者中的应用效果

Effect of integrated Chinese and western medicine nursing in patients with laparoscopic cholecystectomy

目的：探讨中西医结合护理对腹腔镜胆囊摘除术后患者出现的伤口疼痛、胃肠道功能障碍（肛门排气）、术后并发症以及患者对护理总体满意度的影响。方法采用便利抽样法选取2013年4月—2014年5月青岛市立医院住院部收治的84例腹腔镜胆囊摘除术患者作为研究对象，采取随机数字表法将患者分为对照组（42例）和试验组（42例），对照组患者采取围术期常规护理，试验组患者则在常规护理的基础上实施中西医结合护理。采用视觉模拟评分法（VAS）评估两组患者术后伤口疼痛程度，对比两组患者术后首次肛门排气时间、并发症情况及患者对护理的整体满意程度。结果两组患者VAS 评分中对照组为（4．6±2．2）分，试验组为（2．4±1．2）分，差异有统计学意义（P ＜0．05）；患者术后首次肛门排气时间对照组为（14．3±1．1）h，试验组为（7．5±1．2）h，差异有统计学意义（P ＜0．05）；对照组42例患者中出现伤口感染者 2例，恶心、呕吐者 4例，并发症率发生率为 14．3％，试验组42例患者中仅出现恶心、呕吐1例，并发症发生率为2．4％，差异有统计学意义（P ＜0．05）。试验组患者对护理的总满意率为95．24％，对照组为66．67％，试验组患者总满意率高于对照组，差异有统计学意义（P ＜0．05）。结论中西医结合护理应用于腹腔镜胆囊摘除术后患者，可减轻患者术后伤口疼痛，缩短术后患者首次肛门排气时间，降低患者术后并发症发生率，提高患者总体满意度，具有临床应用以及推广价值。

Objective To explore effect of integrated Chinese and western medicine nursing in patient′s wound pain,gastrointestinal dysfunction （first anal exhaust time）,postoperative complication rate and total satisfaction after laparoscopic cholecystectomy.Methods A total of 84 patients with gallstone surgery in our hospital admitted between April 201 3 to May 201 4 were randomly divided into experimental group （42 cases） and control group （42 cases）.Control group patients were treated with routine nursing intervention,while experimental group were treated with routine nursing intervention and integrated Chinese and western medicine nursing.The pain which were evaluated using the visual analogue scale （VAS）,first anal exhaust time, incidence of complications and patients′overall satisfaction were compared.Results The VAS score in the control group was （4.6 ±2.2）and experimental group（2.4 ±1 .2）,the difference was statistically significant （P 〈0.05）;postoperative anal exhaust time of the experimental group was（1 4.3 ±1 .1 ）h,shorter than the control group′s （7.5 ±1 .2）h（P 〈0.05）.2 cases of wound infection,4 cases of nausea and vomiting occurred in the control group,complication incidence rate was 1 4.3%,in the experimental group,only 1 case showed nausea,vomiting,complication rate was 2.4%,there was a statistically significant difference （P 〈0.05）.The total satisfaction in the experimental group （95.24%）was higher than that of the control group （66.67%）,the difference was statistically significant （P 〈0.05 ）.Conclusions Integrated Chinese and western nursing applied on the patients with laparoscopic cholecystectomy can reduce postoperative pain,shorten the first postoperative anal exhaust time,reduce the postoperative complication rate,and enhance patient′s total satisfaction,which has high clinical application and promotion value.