快速康复外科理念在肾上盏入路经皮肾镜取石术围手术期护理中的应用  

Application of fast-track surgery in perioperative nursing of patients with percutaneous nephrolithotomy lithotomy with upper-pole access

作　　者：董春琴 傅文珍[1] 傅亚飞[1] 翁东[1] 

机构地区：[1]浙江省绍兴市人民医院浙江大学绍兴医院泌尿外科,312000

出　　处：《中华现代护理杂志》2014年第17期2102-2105,共4页Chinese Journal of Modern Nursing

摘　　要：目的：探讨快速康复外科（ FTS）理念对经肾上盏入路经皮肾镜取石术（ PCNL）围手术期护理的有效性。方法选择2011年11月-2013年12月在某院接受PCNL术的76例肾结石（ KS）患者，所有患者随机分为两组，每组各38例，干预组患者接受FTS模式护理干预，对照组接受常规护理。统计两组患者的住院时间、治疗费用、生活活动量表BI指数及患者并发症发生情况，并在护理结束后对患者进行护理满意度调查。结果干预组住院时间、治疗费用和BI指数得分分别为（8．8±2．3）d，（10980．6±966．3）元和（84．6±9．4）分，优于对照组的（12．4±3．0）d，（14315．3±1537．3）元和（68．9±7．3）分，差异有统计学意义（t值分别为4．682，9．473，6．741；P＜0．05）。干预组发生术后发热2例，术后疼痛2例，并发症发生率为10．5％；对照组严重出血4例，术后发热6例，术后疼痛2例，并发症发生率为31．6％，干预组优于对照组，差异有统计学意义（χ2＝5．067，P＜0．05）。干预组患者满意率为94．7％，高于对照组的78．9％，差异有统计学意义（χ2＝4．145，P＜0．05）。结论 KS患者经肾上盏入路PCNL围手术期采用FTS护理模式能有效减少并发症的发生，且得到患者认可，值得在临床上进一步推广。Objective To explore the effectiveness of fast-track surgery （ FTS） in perioperative nursing of patients with percutaneous nephrolithotomy lithotomy with upper-pole access （PCNL）.Methods Seventy-six kidney stone （ KS） patients with PCNL in our hospital from November 2011 to December 2013 were chosen and randomly divided into the control group and the intervention group , each with 38 cases.The control group received the routine nursing , and the intervention group received the FTS nursing intervention .The hospital stays, the costs of treatment , the score of BI index of living scale and the incidence of complication were recorded and the patients ’ satisfaction were investigated at the end of nursing in two groups .Results The hospital stays, the costs of treatment, the score of BI index of living scale were respectively （8.8 ±2.3） d, （10 980.6 ±966.3）yuan and （84.6 ±9.4） in the intervention group, and were better than （12.4 ±3.0）d, （14 315.3 ±1 537.3） yuan and （68.9 ±7.3） in the control group, and the differences were statistically significant （t =4.682, 9.473, 6.741, respectively;P 〈0.05）.The incidence rate of complication in the intervention group was 10.5% including 2 cases of postoperative fever and 2 cases of postoperative pain , and was better than 31.6% including 4 cases of severe bleeding , 6 cases of postoperative fever , and 2 cases of postoperative pain in the control group , and the difference was statistically significant （χ2 =5.067, P〈0.05）. The patients’ satisfaction was 94.7%in the intervention group, and was high than 78.9%in the control group, and the difference was statistically significant （χ2 =4.145,P〈0.05）.Conclusions FTS nursing intervention adopted in KS patients with PCNL during perioperative period can effectively reduce the incidence of complications , and be accepted by the patients , and which is worthy of further promotion in clinical practice .

关 键 词：肾结石 围手术期护理 快速康复外科 经皮肾镜超声碎石术 

分 类 号：R473.6[医药卫生—护理学]