快速康复外科理念在肝移植术后患者护理中的应用

Application of the fast track surgery concept in the care of patients after liver transplantation

目的探讨快速康复外科(FTS)理念在肝移植术后患者护理中的应用效果。方法选择医院ICU 2018年12月—2020年12月收治的肝移植术后患者126例为研究对象,按照组间基本特征具有可比性的原则分为对照组与观察组,各63例。对照组给予常规护理,观察组在对照组的基础上实施FTS理念护理。比较两组患者术后中心静脉导管相关血流感染发生率、呼吸机相关肺炎发生率、导尿管相关泌尿道感染发生率、深静脉血栓发生率、气管插管留置时间、胃管留置时间、尿管留置时间、第1次下床时间、ICU住院天数、住院满意度。结果实施基于FTS理念的术后护理后,观察组中心静脉导管相关血流感染、呼吸机相关肺炎、导尿管相关泌尿道感染总发生率低于对照组,差异具有统计学意义(P<0.05);观察组气管插管留置时间、胃管留置时间、尿管留置时间、第1次下床时间、ICU住院天数均短于对照组,护理满意度高于对照组,差异均有统计学意义(P<0.05)。结论FTS理念护理在肝移植术后患者中的应用,可缩短气管插管留置时间、胃管留置时间、尿管留置时间、第1次下床时间、ICU住院天数,降低中心静脉导管相关血流感染、呼吸机相关肺炎、导尿管相关泌尿道感染总发生率,提高患者护理满意度。

Objective To explore the effect of the application of the fast track surgery(FTS)concept in the care of patients after liver transplantation.Methods 126 post-liver transplantation patients admitted to the hospital ICU from December 2018 to December 2020 were selected as study subjects,they were divided into a control group and an observation group of 63 cases each according to the principle of comparability of basic characteristics between groups.The control group was given conventional care and the observation group was given FTS concept care on the basis of the control group.The incidence of postoperative central venous catheter-related bloodstream infection,ventilator-related pneumonia,catheter-related urinary tract infection,deep vein thrombosis,duration of tracheal intubation,duration of gastric tube placement,duration of urinary catheter placement,time to first discharge from bed,number of days in ICU,and satisfaction with hospitalisation were compared between the two groups.Results After the implementation of postoperative care based on the FTS concept,the overall incidence of central venous catheter-related bloodstream infection,ventilator-related pneumonia and catheter-related urinary tract infection in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05),the duration of tracheal intubation,duration of gastric tube placement,duration of urinary catheter placement,time to first discharge from bed and number of days of ICU stay in the observation group were all shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion The application of FTS concept nursing in post-liver transplant patients can shorten the time of tracheal intubation,gastric tube retention,urinary catheter retention,time to first bed discharge and days of ICU stay,reduce the overall incidence of central venous catheter-related bloodstream infection,ventilator-related pneumonia and catheter-related urinary tract infection,and improve patient satisfaction with nursing care.