快速康复外科理念在腹腔镜肝切除患者围手术期护理中的应用

Application of Rapid Rehabilitation Surgery in Perioperative Nursing of Laparoscopic Hepatectomy

目的探讨快速康复外科理念在腹腔镜肝切除患者围手术期护理中的应用。方法方便选取该院2015年10月—2016年11月收治的80例腹腔镜肝切除患者分为对照组与观察组,随机分为对照组和观察组,对照组和观察组各有40例腹腔镜肝切除患者。对照组腹腔镜肝切除患者行常规护理,观察组腹腔镜肝切除患者行围手术期快速康复护理,做好患者的术前护理、术中护理、以及术后护理,术中护理从细节做起,进行体位摆放、术中制动以及心理护理等。对比两组患者焦虑情况、手术情况、护理满意度。结果 (1)观察组患者术后SAS(26.0±2.3)分、VAS(1.0±0.2)分、SDS(28.5±3.1)分和对照组比较,明显较低,差异有统计学意义(P<0.05)。(2)观察组患者首次下床活动时间(1.1±0.4)d、首次肛门排气时间(20.2±7.6)h以及PSQL(2.7±1.2)分与对照组患者首次下床活动时间(2.7±0.9)d、首次肛门排气时间(36.1±0.5)h以及PSQL(4.8±1.9)分比较,明显较低,差异有统计学意义(P<0.05)。(3)观察组患者满意率(100.00%)和对照组(80.00%)比较,明显较高,差异有统计学意义(P<0.05)。结论在肝切除术围手术期内行快速康复护理能有效优化手术指标,提高护理质量。

Objective This paper tries to explore the application of rapid rehabilitation surgery in perioperative nursing of laparoscopic hepatectomy patients.Methods 80 patients with laparoscopic hepatectomy in this hospital from October 2015 to November 2016 were conveniently divided into the control group and the observation group,with 40 cases in each group.The control group of laparoscopic hepatectomy was treated with the routine nursing.The observation group was treated with perioperative rapid rehabilitation and the patients were treated with preoperative nursing,intraoperative care,and postoperative care and in the intraoperative care,the position placement,intraoperative brakes and psychological care were implemented.And then the anxiety,surgery condition,nursing satisfaction of two groups were compared.Results（1） Compared with the control group,the levels of SAS was（26.0±2.3） points,VAS was（1.0±0.2） points and SDS was（28.5±3.1） points in the observation group,significantly lower than the control group（P〈0.05）,with statistically significance.（2）In the observation group,the first time of getting out of bed was（1.1±0.4） d,the first anal exhaust time was（20.2±7.6） h and the PSQL was（2.7±1.2） points,significantly lower then those in the control group of（2.7 ±0.9）d,（36.1±0.5）h and（4.8±1.9）points（P〈 0.05）,with statistical significance.（3）The satisfaction rate was 100.00% of the observation group,significantly higher than that of the control group of 80.00%（P〈0.05）,which was statistically significant.Conclusion In the perioperative period of hepatectomy,rapid rehabilitation nursing can effectively optimize the surgical indicators and improve the nursing quality.