手术室综合护理对腹腔镜胆囊切除术患者应激反应及预后的影响

Effect of Comprehensive Nursing in the Operating Room on Stress Response and Prognosis of Patients Undergoing Laparoscopic Cholecystectomy

目的探讨腹腔镜胆囊切除术患者应用手术室综合护理对患者应激反应及预后的影响。方法选择2019年7月-2021年9月我院收治的60例行腹腔镜胆囊切除术治疗的患者,按随机数字表法分为综合组和常规组,各30例。常规组实施简化流程版手术室护理,综合组实施手术室综合护理。比较手术前后两组血清皮质醇(Cor)、促肾上腺皮质激素(ACTH)、白介素-6(IL-6)、汉密尔顿焦虑自评量表(HAMA)、汉密尔顿抑郁自评量表(HAMD)、手术康复指标及术后并发症。结果两组术后Cor、ACTH、IL-6、HAMA评分、HAMD评分均降低,且综合组低于常规组(P<0.05);综合组术中体温高于常规组(P<0.05);综合组肠鸣音恢复时间、术后进食时间、术后下地活动时间均短于常规组(P<0.05);综合组术后并发症发生率为6.67%,低于常规组的33.33%(P<0.05)。结论腹腔镜胆囊切除术患者应用手术室综合护理,可减轻手术引起的生理、心理应激反应,缩短胃肠功能恢复时间,降低术后并发症发生率,改善预后。

Objective To investigate the effect of comprehensive nursing in the operating room on stress response and prognosis in patients undergoing laparoscopic cholecystectomy.Methods From July 2019 to September 2021,60 patients undergoing laparoscopic cholecystectomy in our hospital were selected and divided into comprehensive group and routine group according to the random number table method,with 30 cases in each group.The routine group implemented simplified process version of operating room nursing,and the comprehensive group implemented comprehensive nursing in the operating room.Serum cortisol(Cor),adrenocorticotropic hormone(ACTH),interleukin-6(IL-6),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),surgical rehabilitation indicators and postoperative complications were compared between the two groups before and after surgery.Results The postoperative Cor,ACTH,IL-6,HAMA score and HAMD score of the two groups decreased,and those of the comprehensive group were lower than those in the conventional group(P<0.05).The body temperature in the comprehensive group was higher than that in the conventional group(P<0.05).The recovery time of bowel sounds,postoperative feeding time and postoperative ambulation time in the comprehensive group were shorter than those in the conventional group(P<0.05).The incidence of postoperative complications in the comprehensive group was 6.67%,which was lower than 33.33% in the conventional group(P<0.05).Conclusion The application of comprehensive nursing in the operating room for patients undergoing laparoscopic cholecystectomy can reduce the physiological and psychological stress response caused by surgery,shorten the recovery time of gastrointestinal function,reduce the incidence of postoperative complications and improve the prognosis.