基于快速康复外科理念的护理干预在老年患者急诊腹腔镜胆囊切除术围手术期的应用效果

Application effect of nursing intervention based on the fast-track surgery concept in perioperative of elderly patients with emergency laparoscopic cholecystectomy

目的探究基于快速康复外科(FTS)理念的护理干预在老年患者急诊腹腔镜胆囊切除术(LC)围手术期的应用效果。方法将我院90例急诊LC老年患者根据单双号分为常规组(常规护理干预)和FTS组(基于FTS理念的护理干预),各45例。观察两组的干预效果。结果术后1、3 d,FTS组的CRP、IL-6、TNF-α和皮质醇水平均低于常规组(P<0.05)。FTS组术后1、4、12、24、48 h的VAS评分均低于常规组(P<0.05)。FTS组术后下床活动时间、进食时间、排气时间及住院时间均短于常规组,术后并发症总发生率低于常规组(P<0.05)。结论基于FTS理念的护理干预能够有效减轻急诊LC老年患者围手术期的炎性反应及应激反应,且镇痛效果显著,患者术后恢复快,并发症发生率低。

Objective To explore the application effect of nursing intervention based on the fast-track surgery(FTS)concept in perioperative of elderly patients with emergency laparoscopic cholecystectomy(LC). Methods Ninty elderly patients with emergency LC in our hospital were divided into conventional group(routine nursing intervention) and FTS group(nursing intervention based on FTS concept) according to odd and even numbers, with 45 cases in each group.The intervention effect of the two groups were observed. Results At 1 and 3 d after operation, CRP, IL-6, TNF-α and cortisol levels in the FTS group were lower than those in the conventional group(P<0.05). VAS score in the FTS group at 1, 4, 12, 24, 48 h after operation was lower than that in the conventional group(P<0.05). The time of postoperative ambulation, feeding time, exhaust time and hospital stay in the FTS group were shorter than those in the conventional group, the total incidence of postoperative complications was lower than that in the conventional group(P <0.05).Conclusion The nursing intervention based on FTS concept can effectively reduce the perioperative inflammatory response and stress response of elderly patients with emergency LC, and has a significant analgesic effect, fast postoperative recovery and low incidence of complications.