快速康复护理路径在肝包虫病患者围手术期管理中的应用  

Effects of enhanced recovery nursing pathway in perioperative management of patients with hepatic echinococcosis

作　　者：汪晓兰 王红英 德吉卓玛 黄紫文 于晓玲[1] 吴德全[1] Wang Xiaolan;Wang Hongying;Deji Zhuoma;Huang Ziwen;Yu Xiaoling;Wu Dequan(Oncology Department,the Second Hospital of Anhui Medical University,Hefei 230601,China;Department of Hepatobiliary Surgery,Shannan People's Hospital of Tibet Autonomous Region,Shannan 856000,China)

机构地区：[1]安徽医科大学第二附属医院肿瘤科,合肥230601 [2]西藏自治区山南市人民医院肝胆外科,856000

出　　处：《中华现代护理杂志》2021年第4期499-503,共5页Chinese Journal of Modern Nursing

基　　金：西藏山南市科技三项项目(SNKJ201822);安徽高校人文社会科学重点研究项目(SK2019A0171)。

摘　　要：目的探讨快速康复护理路径在肝包虫手术患者术后快速康复中的应用效果。方法采用单纯随机抽样法,选取西藏自治区山南市人民医院2017年11月—2019年2月收治的160例肝包虫手术患者为研究对象,随机分为试验组和对照组,每组80例。对照组患者采用普外科常规护理,试验组在常规护理基础上施行快速康复护理路径护理。比较两组患者术后康复指标、疼痛评分和术后并发症情况。结果试验组组患者的首次排气、排便时间为(3.77±3.05)、(23.81±17.29)h,早于对照组的(13.27±8.58)、(37.79±18.23)h,差异有统计学意义(t值分别为4.265、4.975;P<0.01);试验组术后2、4、8、24 h疼痛评分(1.08±1.04)、(1.61±0.85)、(1.13±0.70)、(0.26±0.41)分,低于对照组的(2.41±1.20)、(2.94±0.96)、(2.94±0.96)、(1.33±0.90)分,差异具有统计学意义(t值分别为7.501、9.250、13.650、-8.720;P<0.01)。术后试验组发生肺部感染2例(2.50%),对照组发生13例(16.25%),试验组发生率低于对照组,差异有统计学意义(χ2=8.901,P<0.01)。结论基于快速康复护理路径的标准化护理模式有利于肝包虫病患者术后康复,缩短住院时间,减少术后肺部感染,值得进一步推广。Objective To explore the effect of enhanced recovery nursing pathway in the enhanced recovery after surgery of perioperative patients with hepatic echinococcosis.Methods From November 2017 to February 2019,simple random sampling was used to select 160 hepatic echinococcosis patients with surgery admitted to Shannan People's Hospital of Tibet Autonomous Region as the research object.Patients were randomly divided into experimental group and control group,80 cases in each group.Patients in control group received general surgical routine nursing,and experimental group carried out enhanced recovery nursing pathway on the basis of routine nursing.The postoperative rehabilitation indicators,pain scores and postoperative complications were compared between the two groups.Results The time of first exhaust time and defecation in experimental group was(3.77±3.05)h and(23.81±17.29)h,which was earlier than(13.27±8.58)h and(37.79±18.23)h in control group,and the differences were statistically significant(t=4.265,4.975;P<0.01).The pain scores of experimental group at 2,4,8,and 24 hours after surgery were(1.08±1.04),(1.61±0.85),(1.13±0.70)and(0.26±0.41)lower than those[(2.41±1.20),(2.94±0.96),(2.94±0.96),(1.33±0.90)]of control group,and the differences were statistically significant(t=7.501,9.250,13.650,-8.720;P<0.01).There were 2 cases(2.50%)of lung infection in experimental group and 13 cases(16.25%)in control group.The incidence in experimental group was lower than that in control group,and the difference was statistically significant(χ2=8.901,P<0.01).Conclusions The standardized nursing model based on the enhanced recovery nursing pathway is conducive to the postoperative rehabilitation of patients with hepatic echinococcosis,shortens the hospital stay,and reduces postoperative lung infection complications,which is worthy of further promotion.

关 键 词：肝包虫病 围手术期管理 快速康复护理路径 肝包虫手术 单纯随机抽样 术后快速康复 术后肺部感染 排便时间 

分 类 号：R473.6[医药卫生—护理学]