快速康复外科护理在后腹腔镜下肾上腺切除术中的应用效果

Application of Rapid Rehabilitation Surgical Nursing in Retroperitoneal Laparoscopic Adrenalectomy

目的探讨在后腹腔镜下肾上腺切除术中应用快速康复外科护理的临床效果。方法方便选取2017年6月—2018年6月在该院行后腹腔镜下肾上腺切除术的82例患者,采用随机数字法分成对照组与观察组,每组41例,对照组接受常规护理,观察组在常规护理基础上接受快速康复外科护理,对比两组患者住院时间、首次排便时间、首次排气时间,术后24 h疼痛程度,术后寒战和术后低体温的发生率,以及并发症发生率。结果观察组患者的住院时间、首次排便时间、首次排气时间、术后24 h疼痛程度均显著优于对照组,差异有统计学意义(t=5.01、3.24、4.99、3.23,P<0.05);观察组患者的术后寒战发生率(4.88%)和术后低体温发生率(4.88%)均显著低于对照组的(19.51%)和(29.27%),差异有统计学意义(χ~2=4.1、8.61,P<0.05);对照组患者术后并发症发生率(19.51%)显著高于观察组(4.88%),差异有统计学意义(χ~2=4.1,P<0.05)。结论在后腹腔镜下肾上腺切除术中,快速康复外科护理能够有效维持患者术中、术后体温,并减少术后并发症的发生,有利于患者快速康复。

Objective To investigate the clinical effect of rapid rehabilitation surgical nursing in retroperitoneal laparoscopic adrenalectomy. Methods Convenient select 82 patients underwent laparoscopic adrenalectomy from June 2017 to June 2018 in our hospital. The patients were divided into the control group and the observation group by random number method. Each group had 41 cases. The control group received routine care. The observation group received rapid rehabilitation surgery on the basis of routine nursing, comparing the hospitalization time, the first defecation time, the first exhaust time, the pain level after 24 hours, the incidence of postoperative shiver and postoperative hypothermia, and complications incidence. Results The hospitalization time, the first defecation time, the first exhaust time, and the 24 h postoperative pain were significantly better in the observation group than in the control group. The difference was statistically significant(t=5.01, 3.24,4.99, 3.23, P<0.05). The incidence of postoperative shivering(4.88%) and postoperative hypothermia(4.88%) were significantly lower in the observation group than in the control group(19.51%) and(29.27%), the difference was statistically significant(χ^2=4.1, 8.61, P<0.05);the incidence of postoperative complications in the control group(19.51%) was significantly higher than that in the observation group(4.88%), and the difference was statistically significant(χ^2=4.1, P<0.05). Conclusion In the retroperitoneal laparoscopic adrenalectomy, rapid rehabilitation surgical care can effectively maintain the patient’s intraoperative and postoperative temperature, and reduce the occurrence of postoperative complications, which is conducive to rapid recovery.