加速康复外科理念下早期尿管拔除对腹腔镜胆囊切除术患者的影响  

Effects of early removal of urethral catheter under the concept of enhanced recovery after surgery on patients undergoing laparoscopic cholecystectomy

作　　者：江彦 张小利 胡晓慧 郭丽娜 Jiang Yan;Zhang Xiaoli;Hu Xiaohui;Guo Lina(Department of Physical Examination,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院体检科,450000

出　　处：《中华现代护理杂志》2020年第33期4665-4669,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨加速康复外科(ERAS)理念下早期尿管拔除对腹腔镜胆囊切除术患者的影响。方法选取2018年8月—2019年10月在某医院行腹腔镜胆囊切除术的131例患者为研究对象,采用随机数字表分为对照组66例和观察组65例。对照组采用常规护理方法进行围手术期护理,术后留置尿管时间>12 h;观察组采用ERAS理念进行围手术期护理,术后留置尿管时间≤12 h。比较两组患者排尿相关评价指标和顾客满意度量表得分。结果研究过程中,每组各有1例患者因并发症退出。观察组患者首次拔除导尿管后小便自解59例(92.19%)、尿潴留重新置管5例(7.81%)、尿路刺激征8例(12.50%)、尿常规异常7例(10.94%),与对照组比较,差异均无统计学意义(χ^2值分别为0.334、0.083、0.094、0.403;P>0.05)。观察组排尿疼痛评分为(3.22±0.68)分,低于对照组的(3.41±0.72)分,差异无统计学意义(t=1.540,P>0.05)。观察组患者的顾客满意度量表总分、沟通、安全、症状控制、指导得分分别为(129.05±17.14)、(28.06±3.68)、(24.48±3.59)、(7.82±1.19)、(15.93±2.14)分,高于对照组的(123.02±16.36)、(26.59±3.72)、(23.11±3.46)、(7.16±1.07)、(14.47±2.32)分,差异均有统计学意义(t值分别为2.044、2.256、2.207、3.314、3.714;P<0.05)。结论ERAS理念下腹腔镜胆囊切除术患者早期拔除导尿管是安全可行的,可提高患者满意度。Objective To explore the effects of early removal of urethral catheter under the concept of enhanced recovery after surgery(ERAS)on patients undergoing laparoscopic cholecystectomy.Methods From August 2018 to October 2019,we selected 131 patients who underwent laparoscopic cholecystectomy in a hospital as research objects.Patients were divided into 66 cases in control group and 65 cases in observation group by the random number table.Control group carried out routine nursing for perioperative nursing,and the postoperative indwelling catheter time was more than 12 hours.Observation group implemented ERAS concept for perioperative nursing,and the postoperative indwelling catheter time was less than or equal to 12 hours.We compared the urination-related evaluation indicators and Client Satisfaction Scale scores of patients between two groups.Results During the study,one patient in each group withdrew due to complications.After removing the catheter for the first time in observation group,59 cases(92.19%)urinated by themselves,5 cases(7.81%)were with re-indwelling catheter due to urinary retention,8 cases(12.50%)were with urinary tract irritation,and 7 cases(10.94%)were with abnormal urine routine,compared with control group,the differences were not statistically significant(χ^2=0.334,0.083,0.094,0.403;P>0.05).The urinary pain score of observation group was(3.22±0.68),which was lower than(3.41±0.72)of control group,and the difference was not statistically significant(t=1.540,P>0.05).The total score,communication,safety,symptom control and guidance scores of Client Satisfaction Scale of observation group were(129.05±17.14),(28.06±3.68),(24.48±3.59),(7.82±1.19)and(15.93±2.14)higher than those[(123.02±16.36),(26.59±3.72),(23.11±3.46),(7.16±1.07)and(14.47±2.32)]of control group,and the differences were statistically significant(t=2.044,2.256,2.207,3.314,3.714;P<0.05).Conclusions Early removal of urethral catheter under ERAS concept in patients undergoing laparoscopic cholecystectomy is safe and feasible whic

关 键 词：腹腔镜 胆囊切除术 加速康复外科 导尿管护理 

分 类 号：R473.6[医药卫生—护理学]