临床综合护理在腹腔镜下非离断式Roux-en-Y消化道重建围术期的应用价值

Application value of clinical comprehensive nursing in perioperative period of laparoscopic non-severed Roux-en-Y digestive tract reconstruction

目的探讨临床综合护理在腹腔镜下非离断式Roux-en-Y消化道重建围术期的应用价值。方法采取回顾性研究方式,采取回顾性研究方式,选取本院2016年1月至2019年3月腔镜非离断式Roux-en-Y消化道重建患者100例,分为对照组和研究组,每组50例,对照组采取常规护理,研究组采取临床综合护理。采用汉密尔顿焦虑量表(HAMA)评定患者焦虑情况,采用视觉模拟评分法(VAS)对患者的疼痛程度进行评估,观察并比较两组患者肠鸣音恢复时间、肛门排气时间、住院时间及术后并发症发生率。结果研究组患者HAMA评分为(5.23±3.20)分、VAS评分为(0.31±0.12)分,显著低于对照组患者的(11.52±6.16)分、(0.95±0.20)分,两组比较差异均有统计学意义(均P<0.05);研究组患者肠鸣音恢复时间为(33.28±12.24)h、肛门排气时间为(69.41±17.35)h、住院时间为(7.94±2.57)d,与对照组相比均显著缩短(均P<0.05);研究组患者切口感染1例,切口裂开0例,腹胀1例,营养缺乏1例,总并发症发生率为6.0%,与对照组相比并发症发生率(16.0%)显著降低,差异有统计学意义(P<0.05)。结论在腹腔镜非离断式Roux-en-Y消化道重建患者护理中应用临床综合护理,可使患者焦虑情绪及疼痛状况得到有效改善,在缩短患者胃肠功能恢复时间的同时可降低并发症发生率,从而提高患者预后转归效果。

Objective To explore the value of clinical comprehensive nursing in perioperative period of non-severed Roux-en-Y digestive tract reconstruction under laparoscopy.Methods A retrospective study was conducted on 100 patients with laparoscopic non-severed Roux-en-Y digestive tract reconstruction from January 2016 to March 2019.The patients were randomly divided into control group and study group,the control group was given routine nursing,and the study group was given clinical comprehensive nursing.Hamilton anxiety scale(HAMA)was used to evaluate the anxiety of the patients,and visual simulation score(VAS)was used to evaluate the pain degree of the patients.The recovery time of intestinal sounds,the anal exhaust time,the hospitalization time,and the incidence of postoperative complications were observed and compared between the two groups.Results The HAMA score in the study group was(5.23±3.20),and the VAS score was(0.31±0.12),which were significantly lower than those in the control group[(11.52±6.16),(0.95±0.20)](P<0.05);the recovery time of intestinal sounds,the anal exhaust time,the hospitalization time in the study group were(33.28±12.24)h,(69.41±17.35)h,(7.94±2.57)d,which were significantly shorter than those in the control group(P<0.05).There were 1 cases of incision infection,0 case of incision rupture,1 cases of abdominal distension,and 1 case of nutritional deficiency in the study group,the total incidence of complications was 6%,which was significantly lower than that in the control group(16.0%)(P<0.05).Conclusion The application of clinical comprehensive nursing in the nursing of patients with laparoscopic non-severed Roux-en-Y digestive tract reconstruction can effectively improve the anxiety and pain of patients,shorten the recovery time of gastrointestinal function,reduce the incidence of complications,and thus improve the prognosis of patients.