围手术期精细化护理在胸腔镜手术患者中的应用

Application of perioperative meticulous nursing in patients with video-assisted thoracoscope surgery

目的探讨围手术期精细化护理在胸腔镜手术患者中的应用效果。方法采用便利抽样法,选取2017 年1—12 月成都市第五人民医院收治的胸腔镜手术患者196 例作为研究对象,按随机数字表法将其分为观察组与对照组,各98 例。对照组给予围手术期常规护理,观察组在常规护理基础上给予围手术期精细化护理。统计两组患者术后恢复相关指标及并发症发生率,评估术后不同时间点视觉模拟评分(VAS)及术后患者生活质量评分。结果观察组下床活动时间、导尿管拔除时间、胸管留置时间、肛门排气时间及住院时间均短于对照组,差异有统计学意义(t值分别为25.492、10.205、7.132、 23.087、11.063;P< 0.01)。观察组术后并发症总发生率为8.16%,低于对照组的25.51%,差异有统计学意义(χ2=10.531,P< 0.01)。观察组术后2、48 h 的VAS评分均低于对照组(t 值分别为15.717、21.229;P < 0.01);观察组术后1 周生理职能、生理功能、精神健康及社会功能评分均高于对照组(t 值分别为 8.321、8.232、9.761、9.507;P< 0.01)。结论围手术期精细化护理能有效减少胸腔镜手术患者发生术后并发症,减轻患者术后疼痛,有利于患者术后恢复及生活质量的改善。

Objective To explore the effects of perioperative meticulous nursing in patients with videoassisted thoracoscope surgery. Methods From January to December 2017, we selected 196 patients with video-assisted thoracoscope surgery at Chengdu Fifth People's Hospital as subjects by convenience sampling. All of the patients were divided into observation group and control group with the method of random number table, 98 cases in each group. Control group received perioperative routine nursing. On the bases of routine nursing, observation group carried out perioperative meticulous nursing. We counted the related indexes of postoperative recovery and incidence of complications, evaluate the Visual Analogy Score( VAS) as well as quality of life among patients between two groups at different time points after surgery. Results The times of out-of-bed activity, extubation of catheter, indwell time of chest tube, time of anal exhaust and hospital stay of observation group were shorter than those of control group with statistical differences( t=25.492, 10.205, 7.132, 23.087, 11.063;P < 0.01). The incidence of postoperative complications of observation group was 8.16% lower than that of control group with a statistical difference(χ2=10.531, P< 0.01). The scores of VAS at 2 and 48 hours after surgery of observation group were statistically lower than those of control group( t=15.717, 21.229;P < 0.01). The scores of physical functioning, role-physical, mental health and social functioning of observation group one week after surgery were higher than those of control group( t=8.321, 8.232, 9.761, 9.507;P<0.01). Conclusions Perioperative meticulous nursing can effectively reduce the postoperative complications of patients with video-assisted thoracoscope surgery and relieve patients' postoperative pain which makes for patients' postoperative recovery and improving quality of life.