细节护理对腹腔镜胆囊切除术患者生活质量及术后并发症的影响

Effects of detailed nursing on quality of life and postoperative complications in patients undergoing laparoscopic cholecystectomy

目的分析细节护理对腹腔镜胆囊切除术患者生活质量及术后并发症的影响。方法选取2019年2月至2021年1月于我院就诊的240例胆结石患者,使用随机数字表法将其分为细节护理组(120例,细节护理)与对照组(120例,常规护理)。比较两组的生活质量、围术期指标、并发症发生情况、营养指标、炎症因子、疼痛程度以及护理满意度。结果护理后3 d,两组的生活质量综合评定问卷-74(GQOLI-74)各维度评分均显著升高,且细节护理组显著高于对照组(P<0.05)。细节护理组的进食时间、首次排气时间、住院时间均显著短于对照组(P<0.05)。细节护理组的并发症总发生率明显低于对照组(P<0.05)。护理后3 d,对照组的血浆白蛋白、前白蛋白水平均明显低于护理前及细节护理组(P<0.05);护理后3 d,细节护理组的血浆白蛋白、前白蛋白水平与护理前比较,差异无统计学意义(P>0.05)。护理后3 d,两组的血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均显著高于护理前,但细节护理组的血清TNF-α、IL-6水平显著低于对照组(P<0.05)。术后1、2、3 d,细节护理组的视觉模拟评分法(VAS)评分均显著低于对照组(P<0.05)。细节护理组的护理满意度显著高于对照组(P<0.05)。结论相比于常规护理,细节护理应用于腹腔镜胆囊切术患者中可减少术后并发症,减轻术后疼痛程度及炎症反应,提升营养状态及生活质量,进而提升整体护理满意度,达到促进康复的效果。

Objective To analyze the effects of detailed nursing on quality of life and postoperative complications in patients undergoing laparoscopic cholecystectomy.Methods A total of 240 gallstones patients treated in our hospital from February 2019 to January 2021 were selected and divided into detail nursing group(120 cases,detail nursing)and control group(120 cases,routine nursing)using the random number table method.The quality of life,perioperative indexes,complications,nutritional indexes,inflammatory factors,severity of pain and nursing satisfaction were compared between the two groups.Results On the 3rd day after nursing,the scores of each dimensions of the Generic Quality of Life Inventory-74(GQOLI-74)in the two groups increased significantly,and those in the detailed nursing group were significantly higher than the control group(P<0.05).The feeding time,first exhaust time and hospitalization time of the detail nursing group were significantly shorter than those of the control group(P<0.05).The total incidence of complications in the detail nursing group was significantly lower than that in the control group(P<0.05).On the 3rd day after nursing,the levels of plasma albumin and prealbumin in the control group were significantly lower than those before nursing and the detail nursing group(P<0.05);on the 3rd day after nursing,the levels of plasma albumin and prealbumin in the detail nursing group were not significantly different from those before nursing(P>0.05).On the 3rd day after nursing,the levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)in the two groups were significantly higher than those before nursing,but the levels of serum TNF-αand IL-6 in the detail nursing group were significantly lower than those in the control group(P<0.05).At 1,2 and 3 d after operation,Visual Analogue Scale(VAS)score of the detail nursing group was significantly lower than that of the control group(P<0.05).The nursing satisfaction of the detail nursing group was significantly higher than that of the control group(P<0.05).Conclusion Compared with routine nursing,the detail nursing applied in patients undergoing laparoscopic cholecystectomy can reduce postoperative complications,postoperative pain degree and inflammatory reaction,improve nutritional status and quality of life,and then improve overall nursing satisfaction,so as to achieve the effect of promoting rehabilitation.