快速康复疗法在单孔腹腔镜手术中的临床研究及运用

Clinical Study and Application of Rapid Rehabilitation Therapy in Single Hole Laparoscopic Surgery

目的探讨快速康复疗法在单孔腹腔镜手术中的临床研究及运用。方法选取2019年6月-2020年11月东莞市人民医院妇产科收治的90例择期行腹腔镜手术的患者,根据手术及围术期护理方案分为A组、B组、C组各30例,A组单孔腹腔镜手术,围术期应用快速康复疗法,B组行传统腹腔镜手术,围术期应用快速康复疗法,C组行传统腹腔镜手术,围术期行常规疗法,对三组干预结果进行比较。结果三组手术时间相比,差异无统计学意义(P>0.05),A组进食时间(7.36±1.28)h、肛门排气时间(24.13±2.54)h、术后下床活动时间(6.79±1.34)h及住院时间(4.56±1.04)d均较B组(10.63±1.96)h、(29.45±3.41)h、(8.96±1.87)h、(5.79±1.47)d,C组(42.13±4.21)h、(48.61±5.27)h、(15.12±2.41)h、(8.63±1.97)d短,差异有统计学意义(P<0.05);A组术后12h、1d、2d、3d时VAS评分分别为(3.02±0.84)分、(2.14±0.42)分、(1.65±0.24)分、(1.12±0.13)分,均较B组(4.86±0.91)分、(3.25±0.59)分、(2.34±0.41)分、(1.75±0.32)分及C组(5.91±1.35)分、(4.36±0.81)分、(3.19±0.63)分、(2.35±0.51)分低,差异有统计学意义(P<0.05);A组术后并发症发生率为3.33%,明显较B、C组13.33%、20.00%低,差异有统计学意义(P<0.05)。结论快速康复疗法在单孔腹腔镜手术中应用价值较高,可减轻术后疼痛,减少并发症发生,促使患者尽快康复,缩短住院时间,值得临床推广应用。

Objective To explore the clinical research and application of rapid rehabilitation therapy in single hole laparoscopic surgery.Methods 90 patients undergoing elective laparoscopic surgery in obstetrics and Gynecology Department of our hospital from June 2019 to November 2020 were selected.According to the operation and perioperative nursing plan,they were divided into group A,group B and group C,30 cases in each group.Group A underwent single hole laparoscopic surgery with rapid rehabilitation therapy during perioperative period,group B underwent traditional abdominal endoscopic surgery with rapid rehabilitation therapy during perioperative period,and group C underwent traditional laparoscopic surgery,routine therapy was performed during perioperative period,and the intervention results of the three groups were compared.Results There was no significant difference in the operation time among the three groups(P>0.05).The feeding time(7.36±1.28)h,anal exhaust time(24.13±2.54)h,postoperative ambulation time(6.79±1.34)h and hospital stay(4.56±1.04)d in group A,were significantly shorter than those in group B(10.63±1.96)h,(29.45±3.41)h,(8.96±1.87)h,(5.79±1.47)d,group C(42.13±4.21)h,(48.61±5.27)h(15.12±2.41)h and(8.63±1.97)d,and there was statistical significance(P<0.05);the VAS scores at 12h,1d,2d and 3d in group A were(3.02±0.84),(2.14±0.42),(1.65±0.24)and(1.12±0.13)respectively,lower than those in group B(4.86±0.91),(3.25±0.59),(2.34±0.41),(1.75±0.32)and group C(5.91±1.35)(4.36±0.81),(3.19±0.63)and(2.35±0.51),and there was statistical significance(P<0.05);the incidence of postoperative complications in group A was 3.33%,significantly lower than 13.33%and 20.00%in groups B and C,and there was statistical significance(P<0.05).Conclusion Rapid rehabilitation therapy has high application value in single hole laparoscopic surgery.It can reduce postoperative pain,reduce complications,promote patients to recover as soon as possible and shorten hospital stay.It is worthy of clinical application.