腹股沟疝是通过先天缺损或者老年人腹股沟区腹壁力量减弱造成腹腔脏器通过缺损移位,造成腹股沟区坠胀感、甚至造成肠梗阻、肠坏死等症状,严重影响患者生命安全。据相关统计学资料统计,我国每年有超过100万例的腹股沟疝修补术需要开展,...腹股沟疝是通过先天缺损或者老年人腹股沟区腹壁力量减弱造成腹腔脏器通过缺损移位,造成腹股沟区坠胀感、甚至造成肠梗阻、肠坏死等症状,严重影响患者生命安全。据相关统计学资料统计,我国每年有超过100万例的腹股沟疝修补术需要开展,数量甚至大于欧美和美国相同疾病的总和。目前采用的主要微创的手术方式为TEP、TAPP,但TEP、TAPP两种手术方式创建的操作空间不同,多项研究发现两者对二氧化碳气腹的反应存在差异,本综述就二氧化碳对机体的循环、呼吸、消化系统等方面的影响,以及通过麻醉药物的选择、手术方式的选择、气腹压的选择、术后镇痛、呼吸道管理等围手术的管理来降低二氧化碳气腹的影响。Inguinal hernia is caused by congenital defect or the weakening of abdominal wall strength in the inguinal region of the elderly, which causes the displacement of abdominal organs through the defect, resulting in a sense of bulge in the inguinal region, even causing intestinal obstruction, intestinal necrosis and other symptoms, which seriously affects the life safety of patients. According to relevant statistical data, there are more than 1 million cases of inguinal hernia repair in China every year, and the number is even greater than the sum of the same diseases in Europe, America and the United States. The main minimally invasive surgical methods currently used are TEP and TAPP, but the operating space created by the two surgical methods of TEP and TAPP is different. A number of studies have found that there are differences in the response to carbon dioxide pneumoperitoneum. This review focuses on the effects of carbon dioxide on the body’s circulation, respiration, digestive system and other aspects, as well as the choice of anesthetic drugs, the choice of surgical methods, the choice of pneumoperitoneum pressure, postoperative analgesia, respiratory management and other perioperative management to reduce the impact of carbon dioxide pneumoperitoneum.展开更多
目的研究基于快速康复理念的家属参与式护理模式在胆总管结石围术期管理中的应用效果。方法选取2020年1月—2022年12月于抚州健强第五医院治疗的70例胆总管结石患者作为研究对象,随机分为对照组和观察组,各35例。对照组采用常规护理,观...目的研究基于快速康复理念的家属参与式护理模式在胆总管结石围术期管理中的应用效果。方法选取2020年1月—2022年12月于抚州健强第五医院治疗的70例胆总管结石患者作为研究对象,随机分为对照组和观察组,各35例。对照组采用常规护理,观察组采用基于快速康复理念的家属参与式护理模式,比较2组患者的手术时间、术中出血量、术后首次排气时间、疼痛程度[视觉模拟疼痛评分(visual analogue scale,VAS)]、生活质量[健康调查简表(the MOS item short from health survey,SF-36)评分]、并发症发生率、护理满意度。结果观察组手术时间、术后首次排气时间与对照组相比均更短,术中出血量与对照组相比更少(P<0.05);术后1 d,观察组VAS评分低于对照组(P<0.05)。干预后,观察组SF-36量表各项评分均较对照组更高(P<0.05)。观察组并发症发生率低于对照组,护理满意度高于对照组(P<0.05)。结论将基于快速康复理念的家属参与式护理模式用于胆总管结石围术期管理中,能改善患者手术相关指标及术后疼痛情况,生活质量得到显著提升,同时降低术后并发症发生率,提高患者对护理的满意度。展开更多
文摘腹股沟疝是通过先天缺损或者老年人腹股沟区腹壁力量减弱造成腹腔脏器通过缺损移位,造成腹股沟区坠胀感、甚至造成肠梗阻、肠坏死等症状,严重影响患者生命安全。据相关统计学资料统计,我国每年有超过100万例的腹股沟疝修补术需要开展,数量甚至大于欧美和美国相同疾病的总和。目前采用的主要微创的手术方式为TEP、TAPP,但TEP、TAPP两种手术方式创建的操作空间不同,多项研究发现两者对二氧化碳气腹的反应存在差异,本综述就二氧化碳对机体的循环、呼吸、消化系统等方面的影响,以及通过麻醉药物的选择、手术方式的选择、气腹压的选择、术后镇痛、呼吸道管理等围手术的管理来降低二氧化碳气腹的影响。Inguinal hernia is caused by congenital defect or the weakening of abdominal wall strength in the inguinal region of the elderly, which causes the displacement of abdominal organs through the defect, resulting in a sense of bulge in the inguinal region, even causing intestinal obstruction, intestinal necrosis and other symptoms, which seriously affects the life safety of patients. According to relevant statistical data, there are more than 1 million cases of inguinal hernia repair in China every year, and the number is even greater than the sum of the same diseases in Europe, America and the United States. The main minimally invasive surgical methods currently used are TEP and TAPP, but the operating space created by the two surgical methods of TEP and TAPP is different. A number of studies have found that there are differences in the response to carbon dioxide pneumoperitoneum. This review focuses on the effects of carbon dioxide on the body’s circulation, respiration, digestive system and other aspects, as well as the choice of anesthetic drugs, the choice of surgical methods, the choice of pneumoperitoneum pressure, postoperative analgesia, respiratory management and other perioperative management to reduce the impact of carbon dioxide pneumoperitoneum.
文摘目的研究基于快速康复理念的家属参与式护理模式在胆总管结石围术期管理中的应用效果。方法选取2020年1月—2022年12月于抚州健强第五医院治疗的70例胆总管结石患者作为研究对象,随机分为对照组和观察组,各35例。对照组采用常规护理,观察组采用基于快速康复理念的家属参与式护理模式,比较2组患者的手术时间、术中出血量、术后首次排气时间、疼痛程度[视觉模拟疼痛评分(visual analogue scale,VAS)]、生活质量[健康调查简表(the MOS item short from health survey,SF-36)评分]、并发症发生率、护理满意度。结果观察组手术时间、术后首次排气时间与对照组相比均更短,术中出血量与对照组相比更少(P<0.05);术后1 d,观察组VAS评分低于对照组(P<0.05)。干预后,观察组SF-36量表各项评分均较对照组更高(P<0.05)。观察组并发症发生率低于对照组,护理满意度高于对照组(P<0.05)。结论将基于快速康复理念的家属参与式护理模式用于胆总管结石围术期管理中,能改善患者手术相关指标及术后疼痛情况,生活质量得到显著提升,同时降低术后并发症发生率,提高患者对护理的满意度。
