腹腔镜食管裂孔疝修补术患者围手术期手术配合的精细化管理与应用

Application of refined nursing intervention in the perioperative period of patients undergoing laparoscopic hiatal hernia repair

目的总结分析食管裂孔疝患者围手术期精细化手术配合要点及相应的管理措施,观察其应用效果。方法回顾性分析2023年1—7月北京朝阳医院手术室行腹腔镜食管裂孔疝修补术的84例精细化护理患者资料,对患者非计划停手术情况、手术时间、术中出血量、术中低体温及压力性损伤发生率、手术相关并发症发生率、术后平均住院日,术后满意度进行分析。结果84例患者均顺利完成腹腔镜手术,无中转开腹病例,无非计划停手术病例,平均手术时间(85.65±20.74)min,术中出血量(11.02±4.58)ml,无术中低体温及压力性损伤病例,无术后伤口及补片感染、血气胸、肺部感染、肺不张及胃动力障碍病例,均顺利出院,术后平均住院时间(4.51±1.38)d,满意度96.4%(81/84)。结论充分的术前准备及预防措施、术中精细化配合,术后充分宣教可以提升手术效率,降低并发症发生率,提高患者满意度。

Objective To summarize and analyze the key points of refined nursing intervention for patients with hiatal hernia during the perioperative period,and observe the application effect.Methods A retrospective analysis was conducted on the clinical data of 84 patients with hiatal hernia undergoing laparoscopic hiatal hernia repair at the Beijing Chao-Yang Hospital operation room from January to July 2023.The data of patients with unplanned surgical discontinuance,operation time,intraoperative blood loss,incidence of intraoperative hypothermia and stress injury,incidence of surgery-related complications,average length of stay after surgery and postoperative satisfaction were analyzed.Results All the 84 patients successfully completed laparoscopic surgery,with no conversion to laparotomy or no planned operation.The average operation time was(85.65±20.74)min,the intraoperative blood loss was(11.02±4.58)ml,no intraoperative hypothermia or pressure injury,no postoperative wound and mesh infection,hemopneumothorax,pulmonary infection,attasis or gastric motivation disturbance.The average length of stay was(4.51±1.38)d,and the satisfaction rate was 96.4%(81/84).Conclusion Adequate preoperative preparation,preventive measures,intraoperative fine coordination,and postoperative education can improve the efficiency of surgery,reduce the incidence of complications,and improve patient satisfaction.