摘要
目的探讨LEER模式加速康复外科理念在彝族地区基层医院腹腔镜胆囊切除术中的应用价值。方法选取乐山市金口河区人民医院2021年1-10月应用LEER模式加速康复外科理念的腹腔镜胆囊切除术患者26例为观察组,选取该院2020年1-12月采用常规治疗模式的腹腔镜胆囊切除术患者20例为对照组,分析两组患者的临床治疗情况、术后并发症及术后疼痛情况。结果观察组术后禁食时间、术后住院时间、总住院时间分别为6(6,6)h、2(2,3)d、4(4,6)d,显著短于对照组的24(24,36)h、5(5,6)d、7(7,9)d,差异均有统计学意义(H=351.00、407.50、458.00,均P<0.05)。观察组住院费用为5454.58(5014.11,6016.58)元,显著低于对照组的6611.91(6192.68,7841.73)元,差异有统计学意义(H=420.00,P<0.05);两组患者手术时间、术后并发症发生率差异均无统计学意义(均P>0.05);观察组患者术后6 h视觉模拟评分法疼痛评分为3(3,4)分,轻度疼痛患者占73.07%(19/26);术后24 h视觉模拟评分法评分为2(2,3)分,轻度疼痛患者占92.31%(24/26),术后总体疼痛控制良好。观察组患者住院满意率为96.15%(25/26)。患者均康复出院。结论LEER模式加速康复外科理念用于彝族地区基层医院腹腔镜胆囊切除术能有效促进患者术后康复,促进诊疗理念的改变和整体医疗质量的提高,具有良好的应用价值。
Objective To investigate the clinical application value of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area.Methods Twenty-six patients who underwent laparoscopic cholecystectomy based on the concept of enhancing recovery after surgery using the LEER model in People's Hospital of Jinkouhe District of Leshan from January to October 2021 were included in the observation group.An additional 20 patients who concurrently underwent laparoscopic cholecystectomy and conventional intervention were included in the control group.Clinical efficacy,postoperative complications and postoperative pain were compared between the two groups.Results Postoperative fasting time,length of hospital stay,and total hospital days in the observation group were 6(6,6)hours,2(2,3)days and 4(4,6)days respectively,which were significantly shorter than 24(24,36)hours,5(5,6)days,7(7,9)days in the control group(H=351.00,407.50,458.00,all P<0.05).Hospitalization cost in the observation group was 5454.58(5014.11,6016.58)yuan,which was significantly lower than 6611.91(6192.68,7841.73)yuan in the control group(H=420.00,P<0.05).There were no significant differences in operative time and postoperative complications between the two groups(both P>0.05).At postoperative 6 hours,Visual Analogue Scale score in the observation group was 3(3,4)points,and patients with mild pain accounted for 73.07%(19/26).At postoperative 24 hours,Visual Analogue Scale score in the observation group was 2(2,3)points,and patients with mild pain accounted for 92.31%(24/26).Overall pain was well controlled after surgery.Patient satisfaction rate in the observation was 96.15%(25/26).All patients recovered and were discharged.Conclusion Application of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area can promote postoperative recovery,contribute to changing the theory of diagnosis and treatment,and improve overall medical quality.The enhanced recovery after surgery protocol using the LEER model has a good application value.
作者
蒋康怡
廖明华
朱树云
张珍霞
杨洁
闵鑫
岳国茂
胡成才
白涵
李建平
雷泽华
Jiang Kangyi;Liao Minghua;Zhu Shuyun;Zhang Zhenxia;Yang Jie;Min Xin;Yue Guomao;Hu Chengcai;Bai Han;Li Jianping;Lei Zehua(Department of Hepatobiliary and Pancreatic Surgery,People's Hospital of Leshan,Leshan 614000,Sichuan Province,China;Department of Surgery,People's Hospital of Jinkouhe District of Leshan,Leshan 614700,Sichuan Province,China;Department of Anesthesiology,People's Hospital of Leshan,Leshan 614000,Sichuan Province,China)
出处
《中国基层医药》
CAS
2022年第11期1648-1652,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
四川省卫生健康委员会科研课题项目(20PJ296)
四川省乐山市重点科技项目(19JRK231)。
关键词
胆囊切除术
腹腔镜
医院
县
诊疗模式
加速康复外科
手术时间
住院时间
病人满意度
Cholecystectomy,laparoscopic
Hospitals,county
Practice patterns
Enhanced recovery after surgery
Operative time
Length of stay
Patient satisfaction
