围术期加速康复护理对腹腔镜胆囊切除患者术后早期转归的影响

Effect of enhanced recovery after surgery on the outcome in patients following laparoscopic cholecystectomy

目的:探讨手术室护理人员参与的围术期加速康复外科(ERAS)方案对腹腔镜胆囊切除术(LC)患者术后早期转归的影响。方法:选择ASA分级Ⅰ或Ⅱ级,于2019年1~8月在合肥市第一人民医院行三戳孔LC患者100例,根据不同的护理理念分为观察组和对照组,每组各50例。对照组给予常规护理,观察组实施围术期ERAS方案。结果:两组患者一般情况比较差异均无统计学意义(P>0.05);观察组患者术中发生低体温者降低(P<0.05),术毕至患者首次下床活动时间间隔及首次肛门排气时间均缩短(P<0.05),观察组患者术后总体满意度评分(GSS)高于对照组(P<0.01);两组患者术后恶心呕吐和腹壁戳孔愈合不良发生率差异均无统计学意义(P>0.05)。结论:ERAS方案可降低LC患者术中低体温发生率,利于患者术后良好的转归,有效提高LC患者术后总体满意度。

Objective:To observe the effect of perioperative enhanced recovery program led by nurses in operating room on the outcomes in patients after laparoscopic cholecystectomy.Methods:One hundred ASAⅠ-Ⅱpatients undergoing laparoscopic cholecystectomy(LC)were randomly divided into control group and observational group(n=50 for each).Patients in the observational group were nursed with enhanced recovery after surgery(ERAS)on conventional nursing basis.Results:The general state of patients remained insignificant between the two groups(P>0.05),yet the patients in observational group had lower incidence of hypothermia during surgery,earlier off-bed activities and anus exhaust after operation as well as higher global satisfaction score(GSS)(P<0.05 or P<0.01).There was no significant difference between groups concerning postoperative incidence of vomiting and poor healing of the port-sites(P>0.05).Conclusion:ERAS program led by nurses in operating room for LC can greatly reduce the incidence of intraoperative hypothermia,promote the outcomes and improve the global satisfaction in patients undergoing laparoscopic cholecystectomy.