体位改进用于腹腔镜胆囊切除术围术期中对手术效果、静脉压及并发症的影响

Effect of postural improvement on surgical outcome,venous pressure and complications during perioperative laparoscopic cholecystectomy

[目的]观察体位改进用于腹腔镜胆囊切除术围术期中对手术效果、静脉压及并发症的影响。[方法]选取我院2016年5月—2017年1月行腹腔镜胆囊切除术围术期采用常规体位的病人46例作为对照组,另选取我院2017年2月—2017年10月行腹腔镜胆囊切除术围术期采用体位改进的病人46例作为观察组。对比两组手术效果、不同时段静脉压及并发症发生率。[结果]观察组住院时间及首次排气时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组手术时间与对照组相比,差异无统计学意义(P>0.05);观察组静脉压低于对照组,差异有统计学意义(P<0.05);观察组恶心呕吐、腹腔感染、腰肌酸痛、尿潴留、皮下气肿发生率均低于对照组,差异有统计学意义(P<0.05)。[结论]体位改进运用于腹腔镜胆囊切除术围术期护理中可有效提高手术效果,稳定静脉压,降低并发症发生率。

Objective：To observe the effect of postural improvement on the surgical outcome,venous pressure,and complications dur-ing the perioperative period of laparoscopic cholecystectomy. Methods：A total of 46 patients with laparoscopic cholecystectomy under-went perioperative routine in our hospital from May 2016 to January 2017 were selected as the control group, and the other 46 patients with laparoscopic cholecystectomy underwent improved perioperative postural in our hospital from February 2017 to October 2017 were selected as the observation groups. The effects of surgery,venous pressure,and complication rate at different time were com-pared. Results：The length of hoslpitalization stays and the time of the first evacuation of the observation group were shorter than those of the control group,with less bleeding during operation than those in the control group,and the difference was statistically significant （P〈0. 05）. There was no significant difference in the operation time between the observation group and the control group （P〉0. 05）.The venous pressure of the observation group was lower than that of the control group,the difference was statistically significant （P〈0. 05）. The incidence of nausea and vomiting, abdominal infection,lumbar muscle soreness, urinary retention,and subcutaneous cm-physema of the observation group were lower than those of the control group,and the difference was statistically significant （P〈0. 05）.Conclusions：The improvement of postural position in laparoscopic cholecystectomy could effectively improve the surgical effect,stabi-lize venous pressure,and reduce the incidence of complications.