胸腔镜右上肺叶切除术围术期护理中实施加速康复外科的价值分析

Value analysis of the implementation of accelerated rehabilitation surgery in perioperative nursing of thoracoscopic right upper lobectomy

目的探讨胸腔镜右上肺叶切除术围术期护理中实施加速康复外科的应用价值。方法选取我院胸外科2015年5月～2017年9月实施胸腔镜右上肺叶切除的患者94例,经伦理委员会同意,以随机数字表法分为两组:对照组47例,给予常规的围手术期护理;护理组47例给予加速康复外科护理。比较两组患者的术后疼痛评分和术后疼痛满意度,术后并发症发生率,住院天数和住院费用。结果对照组患者在术后第1天及第3天疼痛评分(NRS)显著高于护理组(P <0.01),术后第5天两组患者NRS评分比较,差异无统计学意义(P> 0.05);对照组镇痛满意度显著低于护理组(P <0.01);对照组并发症发生率19.15%显著高于护理组4.26%;对照组的住院天数和住院费用显著高于护理组(P <0.01)。结论在胸腔镜右上肺叶切除术围术期护理中实施加速康复外科,可促进患者加快缓解术后疼痛,增加镇痛满意度,并显著减少并发症,减少住院时间,节约住院费用,值得推广应用。

Objective To explore the value analysis of the implementation of accelerated rehabilitation surgery in perioperative nursing of thoracoscopic right upper lobectomy. Methods 94 cases who were given thoracoscopic right upper lobectomy,were randomly divided into two groups.The control group(47) was given routine perioperative care,while the nursing group(47) was given enhanced recovery after surgery.The postoperative pain scores,analgesic satisfaction, postoperative complications,length of hospital stay and costs were compared. Restults The NRS on1 st and 3 rd days after surgery of control group were statistically higher than nursing group(P < 0.01),and there was no difference of the NRS on the 5 th postoperative day between the two groups(P > 0.05).Analgesic satisfaction was significantly lower in control group than that in nursing group(P < 0.01),and the incidence of complications in control group(19.15%) was significantly higher than that in nursing group(4.26%)(P < 0.01).Hospital stays and costs in control group were significantly higher than those in nursing group(P < 0.01). Conclusion The implementation of accelerated rehabilitation surgery in the perioperative nursing of thoracoscopic right upper lobectomy can promote patients to speed up the relief of postoperative pain,increase the satisfaction with analgesia,significantly reduce complications,reduce the length of hospital stay,and save the cost of hospitalization, which is worthy of promotion and application.