中西医结合加速康复护理在腹腔镜胆囊切除术围手术期的应用研究

Application Study of Accelerated Rehabilitative Care of Integrated Chinese and Western Medicine for Laparoscopic Cholecystectomy at Perioperative Period

目的:探讨腹腔镜胆囊切除术(LC)患者在围手术期给予中西医结合加速康复护理的应用价值。方法:将268例腹腔镜胆囊切除术患者随机分为对照组和观察组,每组134例;2组患者均给予静脉复合麻醉,采用常规四孔法进行LC术,对照组在围手术期给予常规护理干预,观察组给予中西医结合加速康复护理干预;比较2组手术时间、下床时间、术后排气时间、术后排便时间、术后住院时间、术后住院费用、术后24 h疼痛评分和术后48 h自理能力、并发症发生率。结果:治疗后,观察组患者手术时间、下床时间、术后排气时间、术后排便时间、术后住院时间均短于对照组,住院费用少于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者术后24 h疼痛评分明显低于对照组,术后48 h自理能力评分明显高于对照组,差异均有统计学意义(P<0.05)。并发症发生率观察组为12.69%,对照组为41.79%,2组比较,差异有统计学意义(P<0.05)。结论:腹腔镜胆囊切除术患者在围手术期给予中西医结合加速康复护理,可以明显缓解术后疼痛,提高自理能力,减少并发症,有效促进患者术后康复,从而减少医疗费用。

Objective:To discuss the application value of accelerated rehabilitative care of integrated Chinese and western medicine on patients after laparoscopic cholecystectomy(LC) at perioperative period. Methods: A total of 268 cases of patients after LC were randomly divided into the control group and the observation group, 134 cases in each group. Both groups were given intravenous combined anesthesia and LC by routine four-hole method. At perioperative period,the control group was given routine nursing invention,and the observation group was given accelerated rehabilitative care of integrated Chinese and western medicine. After operation,the operation time,the off-bed time,the exhaust time,the defecation time,the hospitalization time,the hospitalization expenses,the pain score at postoperative 24 hours,the self-care ability at postoperative 48 hours and the incidence of complications in the two groups were compared. Results:After treatment,the operation time, the off-bed time as well as the exhaust time, the defecation time and the hospitalization time after operation in the observation group were shorter than those in the control group,and the hospitalization expense was less,differences being significant(P<0.05). After treatment,the pain score at postoperative 24 hours in the observation group was significantly lower than that in the control group,and the score of self-care ability at postoperative 48 hours was significantly higher than that in the control group,differences being significant(P<0.05). The incidence of complications was 12.69% in the observation group and 41.79% in the control group, the difference being significant(P<0.05). Conclusion: The accelerated rehabilitative care of integrated Chinese and western medicine for patients after LC at perioperative period can significantly relieve postoperative pain,improve self-care ability,reduce complications and effectively promote postoperative rehabilitation,so as to reduce medical costs.