加强术后康复训练对腹腔镜胆囊切除术患者术后肩痛的效果分析

Effect analysis of strengthened postoperative rehabilitation training on postoperative shoulder pain in patients undergoing laparoscopic cholecystectomy

目的观察加强术后康复训练对腹腔镜胆囊切除术患者术后肩痛的效果,分析其临床应用价值。方法选择70例腹腔镜胆囊切除术患者作为观察对象,参照随机数字表法将患者分为对照组和研究组,各35例。对照组患者围术期参照常规流程进行干预,研究组患者在对照组患者的基础上加强术后康复训练。比较两组患者术后肩部疼痛情况[0~10数字疼痛量表(NRS-10)评分],术后恢复情况(术后离床活动时间、首次排气时间、住院治疗天数),干预后生活质量[生活质量核心量表(QLQ-C30)评分],护理质量满意度。结果研究组患者术后6、24、48、72 h的肩部NRS-10评分分别为(5.97±1.25)、(4.36±0.58)、(3.10±0.37)、(1.23±0.14)分,比对照组的(7.04±1.32)、(5.68±0.77)、(4.26±0.65)、(2.45±0.26)分低(P<0.05)。对照组患者术后离床活动时间为(7.98±0.96)h,首次排气时间为(24.85±4.73)h,住院治疗天数为(5.94±1.13)d;研究组患者术后离床活动时间为(5.53±0.78)h,首次排气时间为(16.48±3.68)h,住院治疗天数为(3.64±0.74)d。研究组患者术后离床活动时间、首次排气时间及住院治疗天数比对照组短(t=11.718、8.263、10.074,P<0.05)。干预后,研究组患者QLQ-C30的躯体、认知、情绪、角色功能评分分别为(69.97±6.35)、(73.27±6.93)、(74.85±6.24)、(72.70±6.74)分,比对照组的(61.85±4.68)、(66.71±7.34)、(67.34±6.82)、(62.83±6.13)分高(P<0.05)。对照组患者的护理质量满意度为77.14%(27/35),研究组患者的护理质量满意度为94.29%(33/35),研究组显著高于对照组(χ^(2)=4.200,P=0.040<0.05)。结论加强术后康复训练能够快速有效的缓解腹腔镜胆囊切除术患者术后肩部疼痛程度,加快患者术后恢复,对提升患者生活质量及满意度具有非常积极的作用。

Objective To observe the effect of strengthened postoperative rehabilitation training on postoperative shoulder pain in patients undergoing laparoscopic cholecystectomy,and analyze its clinical value.Methods 70 patients undergoing laparoscopic cholecystectomy were selected as observation subjects,and the patients were divided into the control group and the study group with reference to the method of randomized numerical table,each with 35 cases.Patients in the control group received perioperative intervention according to the routine procedures,and patients in the study group received strengthened postoperative rehabilitation training on the basis of the control group.Patients in both groups were compared in terms of postoperative shoulder pain[0-10 numerical rating scale(NRS-10)score],postoperative recovery(postoperative off-bed ambulation time,time to first exhaustion,days of hospitalization),quality of life[Quality of life Questionnaire-Core 30(QLQ-C30)score]after intervention,and satisfaction with quality of nursing.Results The RNS-10 scores in shoulder were(5.97±1.25),(4.36±0.58),(3.10±0.37)and(1.23±0.14)points in the study group at 6,24,48 and 72 h after surgery,which were lower than(7.04±1.32),(5.68±0.77),(4.26±0.65)and(2.45±0.26)points in the control group(P<0.05).In the control group,the postoperative off-bed ambulation time was(7.98±0.96)h,the time to first exhaustion was(24.85±4.73)h,and the days of hospitalization was(5.94±1.13)d;in the study group,the postoperative off-bed ambulation time was(5.53±0.78)h,the time to first exhaustion was(16.48±3.68)h,and the days of hospitalization was(3.64±0.74)d.The postoperative off-bed ambulation time,time to first exhaustion,and days of hospitalization in the study group were shorter than those in the control group(t=11.718,8.263,10.074;P<0.05).After intervention,the scores of QLQ-C30 for somatic,cognitive,emotional and role function were(69.97±6.35),(73.27±6.93),(74.85±6.24)and(72.70±6.74)points in the study group,which were higher than(61.85±4.68),(66.71±7.34),(67.34±6.82)and(62.83±6.13)points in the control group(P<0.05).The satisfaction with quality of nursing was 77.14%(27/35)in the control group and 94.29%(33/35)in the study group;the study group was significantly higher than the control group(χ^(2)=4.200,P=0.040<0.05).Conclusion Strengthened postoperative rehabilitation training can quickly and effectively alleviate the degree of postoperative shoulder pain in patients undergoing laparoscopic cholecystectomy,accelerate the patients'postoperative recovery,and play a very positive role in improving the quality of life and satisfaction of patients.