摘要
目的 探讨快速康复理念在全腹腔镜下食管裂孔疝修补术患者围术期护理中的临床应用效果,对具体方法与实践内容进行分析.方法 2012年6月—2016年6月采用目的抽样法选取行全腹腔镜下食管裂孔疝修补术的236例患者作为研究对象,按照计算机随机函数法将患者分为对照组和干预组,每组118例.对照组患者接受常规围术期护理,干预组根据快速康复理念进行护理,即术前进行疾病相关知识和手术方面的健康宣教,术中减少导尿管的留置、控温控湿、输液加温、机体保暖、控制输液量,术后早期下床活动、早期拔除胃管、预防性使用血栓治疗仪等快速康复护理措施.比较两组患者早期下床活动时间、肛门排气时间、拔除胃管时间、首次进食时间、术后并发症发生率、住院时间、住院费用的差异.结果 干预组术后24 h内下床活动比例为93.22%,高于对照组的40.68%,差异有统计学意义（χ2=73.611,P〈0.01）;干预组拔除胃管时间、肛门排气时间、首次进食时间分别为（19.5±4.70）、（21.9±2.2）、（23.6±3.1）h,均短于对照组的（26.8±3.6）、（26.5±1.8）、（28.9±4.3）h,差异有统计学意义（t值分别为13.394、17.579、10.861;P〈0.01）;干预组术后并发症发生率为2.54%,低于对照组的18.64%,差异有统计学意义（χ2=16.151,P〈0.05）;干预组术后住院时间为（5.6±2.1）d,住院费用为（28772.9±1890.1）元,低于对照组的（7.8±1.8）d、（30011.7±2113.4）元,差异有统计学意义（t值分别为8.640、4.746;P〈0.01）.结论 快速康复理念在食管裂孔疝修补术患者围术期临床护理中应用,能够促进患者早期下床活动,降低术后并发症的发生率,促进患者术后胃肠道功能快速康复.
Objective To explore the clinical effect of rapid rehabilitation in the perioperative nursing of patients who received total laparoscopic hiatal hernia repair and analyze specific methods and practice. Methods Totally 236 patients who received total laparoscopic hiatal hernia repair between June 2012 and June 2016 were selected by purposive sampling method and were divided into the control group and the intervention group by using the random function method,with 118 patients in each group. Patients in the control group received routine nursing,while patients in the intervention group received nursing based on the concept of rapid rehabilitation,namely,health education related to diseases and operations before operation, reduction of in-dwelling urethral catheter,temperature and humidity control,infusion warming,warmth retention of human body and infusion volume control during operation as well as early ambulation,early removing of stomach tubes, preventive use of thrombus therapeutic instrument and other nursing measures for rapid rehabilitation after operation. The differences in time of early ambulation,time of anal exhaust,time of first feeding, postoperative morbidity,hospitalization time and hospitalization expenses between two groups were compared.Results The proportion of ambulation within 24 hours after surgery in the intervention group was 93.22%,which was higher than that in the control group （40.68%） （χ2=73.611,P〈0.01）;the time of removing stomach tubes,anal exhaust and first feeding were [（19.5±4.70）,（21.9±2.2）,（23.6±3.1）] hours in the intervention group,and they wereshorter than those in the control group [（26.8±3.6）,（26.5±1.8）,（28.9±4.3）] hours （t=13.394,17.579,10.861;P〈0.01）;the incidence rate of postoperative complications in the intervention group was 2.54%,which was lower than that in the control group （18.64%） （χ2=16.151,P〈0.05）;in the intervention group,the postoperative hospitalization time and expenses were （5.6±2.1） days and （28772.9±1890.1） yuan,and they were lower than those in the control group [（7.8±1.8） days,（30011.7±2113.4） yuan] （t=8.640,4.746;P〈0.01）.Conclusions The application of rapid rehabilitation in the perioperative nursing of patients with hiatal hernia repair enables patients to ambulate earlier,reduce the incidence of postoperative complications and accelerate the recovery of intestinal functions after operation.
出处
《中华现代护理杂志》
2017年第3期404-408,共5页
Chinese Journal of Modern Nursing
关键词
围手术期护理
腹腔镜
疝
食管裂孔
快速康复护理理念
Perioperative nursing
Laparoscope
Hernia
esophageal hiatus
Rapid rehabilitation nursing
