循证护理用于结石性胆囊炎胆囊切除术围手术期患者对其疼痛情况及不良反应的影响

Effect of Evidence-based Nursing on Pain and Adverse Reactions of Patients with Calculous Cholecystitis during Perioperative Period of Cholecystectomy

目的:探讨循证护理用于结石性胆囊炎胆囊切除术围手术期患者对其疼痛情况及不良反应的影响。方法:选取2019年6月—2020年6月广州市第一人民医院收治的结石性胆囊炎胆囊切除术患者140例,依照随机数字表法将患者分为对照组和干预组,对照组:常规围手术期护理,干预组:循证护理。比较两组疼痛情况、睡眠状况、手术状况、应激反应、免疫情况、炎症情况、肠道屏障功能、不良反应。结果:术后第1、2和3天,与对照组比较,干预组疼痛情况均更轻微,睡眠状况均更好,差异均有统计学意义(P<0.05);干预组手术时间、住院时间均更短,术中出血量更少,术后排气时间更早,差异均有统计学意义(P<0.05);与对照组比较,干预组护理后应激反应更小,差异均有统计学意义(P<0.05);干预组护理后CD3^(+)、CD4^(+)指标均较对照组高,差异均有统计学意义(P<0.05);与对照组比较,干预组护理后炎症指标均更低,肠道屏障功能更好,差异均有统计学意义(P<0.05);干预组不良反应发生率较对照组更低,差异有统计学意义(P<0.05)。结论:结石性胆囊炎胆囊切除术围手术期中,循证护理应用效果较好,更有利于减轻患者疼痛感,减少不良反应出现,使用价值高。

Objective:To investigate the effect of evidence-based nursing on pain and adverse reactions of patients with calculous cholecystitis during perioperative period of cholecystectomy.Method:A total of 140 patients with calculous cholecystitis undergoing cholecystectomy admitted to Guangzhou First People's Hospital from June 2019 to June 2020 were selected.According to the random number table,the patients were divided into a control group and an intervention group.The control group:routine perioperative nursing,and the intervention group:evidence-based nursing.The pain status,sleep status,surgical status,stress response,immune status,inflammation status,intestinal barrier function and adverse reactions between the two groups were compared.Result:On the 1st,2nd and 3rd day after surgery,compared with the control group,the pain situation in the intervention group were milder,the sleep condition in the intervention group were better,the differences were statistically significant(P<0.05);in the intervention group,the surgical time and hospital stay were shorter,intraoperative bleeding was less,postoperative exhaust time was earlier,with statistically significant differences(P<0.05);after nursing,compared with the control group,the stress response in the intervention group were smaller,the differences were statistically significant(P<0.05);after nursing,the CD3^(+)and CD4^(+)indicators in the intervention group were higher than those in the control group,the differences were statistically significant(P<0.05);after nursing,compared with the control group,the inflammatory status of the intervention group were lower,the intestinal barrier function of the intervention group were better,the differences were statistically significant(P<0.05);the incidence of adverse reactions in the intervention group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:During perioperative period of cholecystectomy for calculous cholecystitis,evidence-based nursing application is better,more conducive to reducing the pain of patients,reduce the occurrence of adverse reactions,with high value.