快速康复外科护理对高龄腹腔镜胆囊切除术患者手术应激及术后恢复的影响

The effects of fast track surgery and nursing on surgical stress response and postoperative recovery for elderly patients with laparoscopic cholecystectomy

目的探讨快速康复外科护理对高龄腹腔镜胆囊切除术患者手术应激及术后恢复的影响。方法将84例拟实施腹腔镜胆囊切除术的80岁及以上患者随机分为实验组(n=42)和对照组(n=42),实验组在手术前、手术中、手术后给予快速康复外科护理措施,对照组围手术期给予常规护理,比较两组的手术应激及术后恢复情况。结果实验组术后24 h的皮质醇水平、肾上腺素水平、汉密尔顿焦虑量表评分均低于对照组,差异有统计学意义(P<0.05);实验组术后下床活动时间、肛门排气时间、恢复正常饮食时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论快速康复外科护理可降低高龄腹腔镜胆囊切除术患者的手术应激反应,缩短住院时间,有利于高龄患者的术后恢复。

Objective To explore the effects of fast track surgery and nursing on stress response and postoperative recovery for elderly patients with laparoscopic cholecystectomy. Methods Totally 84 patients aged 80 years old and above for laparoscopic cholecystectomy were randomly divided into the experimental group （n=42）and the control group（n=42）according to admission order. The control group was given routine care during perioperative period,and the experimental group was given fast track surgery and nursing during the whole period of surgery. The stress response and postoperative recovery between two groups were compared. Results The concentrations of cortisol,epinephrine and the score of Hamilton anxiety scale in the experimental group were significantly lower than those in the control group （P〈0.05）. Time to ambulate after surgery,time of anal exhaust,time of having normal diet,length of hospital stay in the experimental group were all less than those in the control group,and the differences were statistically significant （P〈0.05）. Conclusion The fast track surgery and nursing can reduce surgical stress response of patients with laparoscopic cholecystectomy,and shorten the length of hospital stay,and accelerate the recovery after surgery for elderly patients.