快速康复外科护理联合中医康复在腔镜胆囊切除术后中的应用研究  

Study on Application of Enhanced Recovery after Surgery Combined with Rehabilitation of Chinese Medicine after Laparoscopic Cholecystectomy

作　　者：朱晓平[1] 金惠明[1] 钱红燕[1] ZHU Xiaoping;JIN Huiming;QIAN Hongyan

机构地区：[1]嘉兴市中医医院

出　　处：《新中医》2020年第1期165-168,共4页New Chinese Medicine

基　　金：浙江省嘉兴市科技局课题（2018AD32132）

摘　　要：目的:观察快速康复外科护理联合中医康复对腹腔镜胆囊切除(LC)患者术后恢复效果及生活质量的影响。方法:将LC患者160例随机分为4组,各得40例;对照组1组行传统常规护理,对照组2组行快速康复外科护理(ERAS),对照组3组行传统常规护理联合中医康复护理,观察组行ERAS联合中医康复护理;观察比较患者首次下床活动时间、进食时间、首次排气时间、住院天数,患者术后第1天、第3天的舒适状况量表(GCQ)及疼痛视觉模拟评分法(VAS)评分,手术前后C-反应蛋白(CRP)的变化。结果:治疗后,观察组患者首次下床时间、进食时间、首次排气时间与住院天数均短于对照1组、对照2组、对照3组,两两比较,差异均有统计学意义(P <0.05)。术后1天、3天,各组患者GCQ、VAS评分均较术前明显改善(P <0.05);且观察组术后GCQ、VAS评分较对照1组、对照2组、对照3组改善更显著(P <0.05)。术后1天,各组CRP水平均较术前显著升高(P <0.05);但观察组CRP水平低于其他3个对照组(P <0.05);术后3天,各组CRP水平均较术后1天显著降低(P <0.05);且观察组CRP水平显著低于其他3个对照组(P <0.05)。结论:ERAS联合中医护理干预LC患者疗效确切,可有效缩短胃肠道恢复时间,改善术后CRP水平,提高患者生活质量,疗效优于单独给予传统常规护理、ERAS以及常规护理联合中医护理。Objective:To observe the effect of enhanced recovery after surgery combined with rehabilitation of Chinese medicine on the recovery and quality of life of patients after laparoscopic cholecystectomy(LC). Methods:A total of 160 cases of LC patients were randomly divided into four groups, 40 cases in each group. The control group 1 was given routine nursing;the control group 2 was given enhanced recovery after surgery(ERAS);the control group 3 was given routine nursing and rehabilitation nursing of Chinese medicine;the observation group was given ERAS and rehabilitation nursing of Chinese medicine. The time of the first out-of-bed activity,the time of starting to eat,the time of the first anal exhaust,the days of hospitalization,the scores of General Comfort Questionnaire(GCQ) and Visual Analogue Scale(VAS) on the first and third day after surgery,and the changes of C-reactive protein(CRP) before and after treatment in the two groups were observed and compared. Results:After treatment,the time of the first out-of-bed activity,the time of starting to eat and the time of the first anal exhaust in the observation group were earlier than those in the other three groups,and the days of hospitalization were less than those in the other three groups,differences being significant(P < 0.05). On the first and third day after surgery,the scores of GCQ and VAS in each group were significantly improved when compared with those before surgery(P < 0.05);and the improvement of the above two scores in the observation group was more significant than that in the other three groups(P < 0.05)(Table 3). On the first day after surgery, the level of CRP in each group was significantly increased when compared with that before surgery(P < 0.05),but the level in the observation group was lower than those in the other three groups(P < 0.05);on the third day after surgery,the level of CRP in each group was significantly decreased when compared with that on the first day after surgery(P < 0.05), and the level in the observation group was signif

关 键 词：腹腔镜胆囊切除术 快速康复外科护理 中医康复护理 穴位贴敷 推拿按摩 

分 类 号：R473.6[医药卫生—护理学]