基于快速康复外科理论支持下的饮食护理干预 对腹腔镜胆囊切除患者康复效果的影响

Impact of diet nursing intervention on patients＆#39; rehabilitation effect of gallbladder removal under laparoscope based on the surgical theoretical support of quick recovery

目的 探讨基于快速康复外科理论支持下饮食护理干预对腹腔镜胆囊切除患者康复效果的影响.方法 选择2014年6月至2015年12月在本院行腹腔镜胆囊切除术的患者110例为研究对象,采用随机数字表法分为观察组和对照组,各55例.对照组给予围术期常规护理,观察组实施快速康复外科理论下的饮食护理干预.比较两组术后营养学指标、胃肠功能、并发症、患者满意度.结果 观察组患者术后下床活动时间、肛门排气时间、进食时间、排便时间、停止输液时间、住院时间均明显短于对照组 （t=11.481, 11.171, 19.509, 8.479, 2.966, 5.889, P〈0.05）;术后7d,观察组血液白蛋白（ALB）、前白蛋白（PRE）、转铁蛋白（TRF）、视黄醇结合蛋白（RbP）等指标均明显高于对照组（t=7.038, 5.971, 8.540, 10.383, P〈0.05）;观察组术后并发症总发生率30.91%明显低于对照组52.73%（Х^2=5.380, P〈0.05）;满意度94.55%明显高于对照组81.82%（Х^2=4.274, P〈0.05）.结论 基于快速康复外科理论支持下的饮食护理干预有助于改善腹腔镜胆囊切除术患者术后营养不良状态,促进胃肠功能恢复,减少并发症,提高患者满意度.

Objective To discuss about the impact of diet nursing intervention on patients＇ rehabilitation effect of gallbladder removal under laparoscope based on the surgical theoretical support of quick recovery.Methods A total of 110 patients conducted with gallbladder removal under laparoscope in this hospital from June, 2014 to December, 2015 were selected as the study objects.Random number table was used to divide into observation group and control group where there were 55 patients each.Usual care was given to control group during perioperative period and diet nursing intervention was given to observation group based on surgical theoretical support of quick recovery to compare patients＇ satisfaction of nutritional indicator, gastrointestinal function and complication of two groups after operations.Results The postoperative off-bed activity time,anus exhaust time,time of taking food,defecation time,time of stopping transfusion and length of stay of patients in observation group were significantly shorter than control group （t=11.481, 11.171, 19.509, 8.479, 2.966, 5.889, P〈0.05）.7 days after operation, the indicators of ALB, PRE, TRF and RbP of the observation group were significantly higher than that of the control group（t=7.038, 5.971, 8.540, 10.383, P〈0.05）.The total occurrence rate （30.91%） of postoperative complication in observation group was significantly lower than 52.73% that was in control group（Х^2=5.380, P〈0.05）.The satisfaction that was 94.55% was significantly higher than that of the control group＇s 81.82%（Х^2=4.274, P〈0.05）.Conclusion The diet nursing intervention based on the surgical theoretical support of quick recovery can help improve the postoperative malnutrition state of patients for gallbladder removal under laparoscope,promote the recovery of gastrointestinal function,reduce complications and improve the satisfaction of patients.