临床护理路径在腹腔镜肝切除术中的应用

Application of clinical nursing pathway in laparoscopic hepatectomy

目的探究临床护理路径在腹腔镜肝切除术中的应用效果。方法选取哈尔滨医科大学附属第一医院2014年6月-2016年6月收治的90例腹腔镜肝切除术患者，按照就诊时间顺序分为对照组与观察组，每组各45例，对照组仅给予常规护理，观察组给予临床护理路径，对比两组患者下床活动时间、首次肠鸣音时间、首次肛门排气时间、首次排便时间、住院时间、住院费用、健康教育知识及满意度评分、并发症发生率及术后生活质量。结果观察组下床活动时间、首次肠鸣音时间、首次肛门排气时间、首次排便时间、住院时间均较对照组短。住院费用较对照组少，差异有统计学意义（P〈0．05）。两组健康教育后健康知识评分均较健康教育前高，观察组较对照组升高更加显著，差异有统计学意义（P〈0．05）。观察组出血、皮下气肿、切口感染及尿潴留发生率均较对照组低，差异有统计学意义（P〈0．05）。观察组躯体疼痛、生理功能、精神健康、社会功能及总体健康评分均较对照组高，差异有统计学意义（P〈0．05）。结论临床护理路径相比于常规护理可缩短康复时间，提高患者健康教育知识程度及满意度，降低并发症发生率，安全性较高，并促进改善患者的生活质量。

Objective To explore application effect of clinical nursing pathway in laparoscopic hepatectomy. Methods 90 patients with laparoscopic hepatectomy in the First Affiliated Hospital of Harbin Medical University from June 2014 to June 2016 were selected. All the patients were divided into control group and observation group according to the registration order, 45 cases in each group. The routine nursing was used in control group, clinical nursing pathway was applied in observation group. Time of off-bed, the first time of bowel sound, the first time of anal exhaust, the first time of defecation, length of hospital stay, hospital expense, health education knowledge and satisfaction score, incidence rate of complication, postoperative quality of life between two groups were compared. Results Time of off-bed, the first time of bowel sound, the first time of anal exhaust, the first time of defecation, length of hospital stay in observation group were shorter than those in control group, hospital expense in observation group was less than that in control group, with statistically significant differences （P 〈 0.05）. The health knowledge scores of two groups after health edu- cation were higher than before health education, the score of observation group was significantly higher than that of control group, with statistically＇ significant differences （P 〈 0.05）. The incidence rates of bleeding, subcutaneous emphy- sema, incision infection and uroschesis in observation group were lower than those in control group, with statistically significant differences （P 〈 0.05）. The scores of body pain, physical function, mental health, social function and overall health in observation group were higher than those in control group, with statistically significant differences （P 〈 0.05）. Conclusion Clinical nursing pathway can shorten recovery time, improve health education knowledge and satisfaction degree of patients, reduce the incidence rate of complication, has higher security, and promote to improve the patient＇s quality of life when compared with routine nursing.