多学科合作快速康复外科在腹股沟疝修补术中的应用

Application of multidisciplinary collaborative fast-track surgery in inguinal hernia repair

目的 探讨多学科合作快速康复外科在腹股沟疝修补术中的应用效果。方法 64例腹股沟疝患者作为研究对象,随机分为对照组和研究组,各32例。两组患者均进行腹股沟疝修补术,对照组患者接受常规围术期干预,研究组患者接受多学科合作快速康复外科干预。比较两组汉密尔顿焦虑量表(HAMA)评分与汉密尔顿抑郁量表(HAMD)评分,术后各康复时间,术后视觉模拟评分法(VAS)评分,并发症发生情况及满意度评分。结果 干预后,两组患者的HAMA评分与HAMD评分均显著低于本组干预前,且研究组患者HAMA评分(6.71±1.28)分与HAMD评分(6.34±1.35)分均显著低于对照组的(10.63±1.57)、(9.78±1.41)分,差异具有统计学意义(P<0.05)。研究组患者首次下床时间、肠鸣音恢复时间、首次进食时间、疼痛持续时间及住院时间分别为(11.76±2.53)h、(5.48±1.28)h、(8.22±2.16)h、(4.16±0.72)d、(5.72±1.35)d,均显著短于对照组的(18.43±3.68)h、(9.23±1.54)h、(11.56±2.73)h、(6.32±0.89)d、(7.68±2.42)d,差异具有统计学意义(P<0.05)。研究组患者术后1、3、5 d时的VAS评分分别为(5.12±1.26)、(2.15±0.37)、(0.82±0.13)分,均显著低于对照组的(6.91±1.44)、(4.32±0.52)、(2.03±0.28)分,差异具有统计学意义(P<0.05)。研究组患者并发症发生率6.25%显著低于对照组的25.00%,满意度评分(94.24±3.56)分显著高于对照组的(80.46±3.75)分,差异具有统计学意义(P<0.05)。结论 多学科合作快速康复外科可有效改善腹股沟疝患者的心理状况,缓解术后疼痛,减少术后并发症,缩短术后康复时间,患者满意度较高,在腹股沟疝修补术患者中具有较高的应用价值。

Objective To discuss the application effect of multidisciplinary collaborative fast-track surgery in inguinal hernia repair.Methods A total of 64 patients with inguinal hernia as study subjects were randomly divided into control group and research group,with 32 cases in each group.Both group underwent inguinal hernia repair.The control group received perioperative intervention,and the research group received multidisciplinary collaborative fast-track surgery.The Hamilton anxiety scale(HAMA) score and Hamilton depression scale(HAMD) score,postoperative rehabilitation time,postoperative visual analogue scale(VAS)score,occurrence of complications,and satisfaction score were compared between the two groups.Results After intervention,the HAMA score and HAMD score of the two groups were significantly lower than those of this group before treatment;the HAMA score(6.71±1.28) points and HAMD score(6.34±1.35) points of the research group were significantly lower than(10.63±1.57) and(9.78±1.41) points of the control group.All the differences were statistically significant(P<0.05).The first off-bed time,recovery time of bowel sounds,the time of eating for the first time,the duration of pain and hospitalization time of the research group were(11.76±2.53) h,(5.48±1.28) h,(8.22±2.16) h,(4.16±0.72) d and(5.72±1.35) d,which were significantly shorter than(18.43±3.68) h,(9.23±1.54) h,(11.56±2.73) h,(6.32±0.89) d and(7.68±2.42) d of the control group,and the difference was statistically significant(P<0.05).The VAS score of the research group at 1,3 and 5 d postoperatively were(5.12±1.26),(2.15±0.37) and(0.82±0.13) points,which were significantly lower than(6.91±1.44),(4.32±0.52) and(2.03±0.28) points of the control group,and the difference was statistically significant(P<0.05).The complication rate 6.25% of the research group were significantly lower than 25.00% of the control group,and the satisfaction score(94.24±3.56) points was significantly higher than(80.46±3.75) points of the control group.All the differences were statistically significant(P<0.05).Conclusion Multidisciplinary collaborative fast-track surgery can effectively improve the psychological status of patients,relieve postoperative pain,reduce postoperative complications,shorten postoperative rehabilitation time with high patients satisfaction.It has high application value in patients with inguinal hernia repair.