腹股沟疝日间手术患者护理模式的探讨与分析

Discussion and analysis of nursing model for inguinal hernia patients undergoing day surgery

目的探讨与分析日间手术治疗腹股沟疝患者的护理模式。方法回顾性分析2017年1月至2019年1月,首都医科大学附属北京朝阳医院疝和腹壁外科就诊的3266例腹股沟疝日间手术患者。其中,儿童疝患者1111例(34.0%),成人疝患者根据手术方式不同分为开放组和腹腔镜组。开放组患者1256例(38.46%),腹腔镜组患者例899(27.54%),记录全部患者围手术期护理的并发症与相应的处理对策。结果所有患者手术过程顺利,儿童疝组围手术期出现尿浸湿伤口敷料24例(2.2%),活动后出现伤口敷料脱落13例(1.2%),急性疼痛21例(1.9%);成人疝组围手术期出现排尿困难48例(2.2%),急性疼痛69例(3.2%),发热33例(1.5%),体位性低血压12例(0.6%),恶心呕吐20例(0.9%);所有成人组患者围手术期出现特殊事件5例(0.2%),术后转普通病房7例(0.3%),夜间再次急诊就诊11例(0.5%)。所有患者随访期间均未出现伤口感染、液化等并发症。结论在日间手术治疗腹股沟疝患者的围手术期中,良好的腹股沟疝日间手术护理模式,以及定期密切的随访,能显著提升临床治疗效率,有助于减少患者围手术期并发症的发生及早日康复。

Objective To explore and analyze the nursing mode of inguinal hernia patients undergoing day surgery.Methods The data of 3266 patients with inguinal hernia undergoing day surgery from January 2017 to January 2019 in the department of hernia and abdominal wall surgery of Beijing Chaoyang Hospital were retrospectively analyzed.There were 1111(34.0%)cases of pediatric inguinal hernia,and adult patients with inguinal hernia were divided into open group and laparoscopic group according to different surgical methods,with 1256(38.46%)cases of open hernia repair group and 899(27.54%)cases of laparoscopic group.All patients'perioperative nursing complications and corresponding treatment strategies were recorded.Results All patients had successful operations.In the children group,24(2.2%)patients occurred urine-soaked wound dressing during perioperative period,13(1.2%)patients occurred wound dressing shedding after activity,and 21(1.9%)patients presented with acute pain.In the adults group,48(2.2%)patients presented dysuria,69(3.2%)patients presented acute pain,33(1.5%)patients presented fever,12(0.6%)patients presented postural hypotension,and 20(0.9%)patients presented nausea and vomiting.In all the adult patients,special events occurred in 5(0.2%)patientsduring perioperative period,7(0.3%)patients were transferred to the general ward after surgery,and 11 patients(0.5%)returned to the emergency department at night.No wound infection,liquefaction and other complications occurred in all patients during follow-up.Conclusions During the perioperative period of day surgery for inguinal hernia patients,good day operation nursing mode and regular follow-up can significantly improve the clinical treatment efficiency,and reduce the occurrence of perioperative complications and promote early recovery of patients.