医护一体化模式在腹腔镜下食管裂孔疝修补术联合胆囊切除中的应用效果

Experience in cooperation between laparoscopic repair of esophageal hiatus hernia and cholecystectomy

目的总结分析医护一体化模式在腹腔镜下食管裂孔疝修补联合胆囊切除手术的应用效果。方法选取2020年8月至2022年8月于新疆维吾尔自治区人民医院手术室行腹腔镜下食管裂孔疝修补并胆囊切除的100例患者为研究对象,对照组采用手术室护理常规方法,干预组在对照组的常规护理基础上实施医护一体化模式。比较2组患者平均手术时间、术中出血量、平均住院时间、手术室护理不良事件发生率、患者满意度。结果对照组患者平均手术时间(106.94±23.00)min、术中出血量(49.8±26.15)ml、平均住院时间为(6.52±1.07)d;干预组患者分别为(93.84±7.13)min、(39.00±12.98)ml、(5.94±0.87)d,差异均有统计学意义(P<0.05)。对照组患者手术室护理不良事件发生率为14.0%、护理满意度为90.0%,观察组组分别为2.0%、94.0%,差异均有统计学意义(P<0.05)。结论医护一体化模式在腹腔镜下行食管裂孔疝修补并胆囊切除术是安全可行的,术中医护良好配合缩短了手术时间,且安全性高、疗效好,也在一定程度上达到了切口恢复美观术后美学的需求,值得临床应用与推广。

Objective To summarize and analyze the application effect of integrated medical care mode in laparoscopic hiatus hernia repair combined with cholecystectomy.Methods A total of 100 patients who underwent laparoscopic hiatus hernia repair and cholecystectomy in the operating room of the People’s Hospital of Xinjiang Uygur Autonomous Region from August 2020 to August 2022 were selected as the study subjects.The control group was treated with routine nursing methods in the operating room,and the intervention group was treated with integrated nursing mode based on routine nursing of the control group.The average operation duration,intraoperative blood loss,average length of stay,incidence of adverse events in operating room nursing,and patient satisfaction were compared between the two groups.Results In control group,the mean operation duration was(106.94±23.00)min,the amount of intraoperative blood loss was(49.8±26.15)ml,and the mean hospital stay was(6.52±1.07)d.In the intervention group,the mean operation duration was(93.84±7.13)min,the amount of intraoperative blood loss was(39.00±12.98)ml,and the mean hospital stay was(5.94±0.87)d,with statistical significance(P<0.05).The incidence of adverse events in operating room nursing was 14.0%and nursing satisfaction was 90.0%in control group,and 2.0%and 94.0%in observation group,respectively,with statistical significance(P<0.05).Conclusion The integrated medical care mode is feasible and safe in laparoscopic hiatus hernia repair and cholecystectomy.The good coordination of intraoperative medical care can shorten the operation time,with high safety and good efficacy,and can also meet the postoperative aesthetic needs to a certain extent,which is worthy of clinical application and promotion.