快速康复外科理念联合针对性护理对腹腔镜盆腔术后症状性静脉血栓的影响  

The effect of enhanced recovery after surgery on the symptomatic deep venous thrombosis after laparoscopic pelvic surgery

作　　者：陈雪莲[1] 李腾成[1] 李文标[1] 杨飞[1] 湛海伦[1] Chen Xuelian;Li Tengcheng;Li Wenbiao;Yang Fei;Zhan Hailun(Department of Urology,Linnan Hospital,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院岭南医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2021年第5期392-395,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的总结快速康复外科理念及针对性护理对腹腔镜盆腔手术后有症状下肢静脉血栓的影响。方法入选2017年1月至2020年12月我院腹腔镜泌尿盆腔手术128例作为研究组,包括腹腔镜前列腺癌根治术52例,腹腔镜膀胱癌根治术42例,腹腔镜输尿管膀胱再植术34例,所有手术患者采用快速康复理念进行围手术期护理,同时对下肢深静脉血栓高危和极高危患者实行针对性护理。回顾性收集2015年1月至2016年12月所有的腹腔镜行盆腔手术56例患者作为对照组,观察比较两组患者的下肢深静脉血栓发生情况。结果所有患者手术均获成功,两组的术中失血量及手术时间差异无统计学意义。研究组的术后连续卧床时间、肛门排气时间、盆腔引流管拔除时间及住院时间均较对照组缩短,差异有统计学意义。研究组有下肢静脉血栓2例,观察组有下肢静脉血栓6例,两组下肢深静脉血栓的发生差异有统计学意义(P=0.032),两组均未发生肺栓塞。结论快速康复外科理念及针对性护理可减少腹腔镜盆腔手术后有症状下肢静脉血栓的发生。Objective To summarize the effect of enhanced recovery after surgery(ERAS)and targeted nursing on the symptomatic deep venous thrombosis after laparoscopic pelvic surgery.Methods From January 2017 to December 2020,128 cases of laparoscopic pelvic surgery were enrolled as the study group,including 52 cases of laparoscopic radical prostatectomy,42 cases of laparoscopic radical bladder cancer,and 34 cases of laparoscopic ureterobladder replantation.All patients were underwent perioperative nursing care with the concept of ERAS.At the same time,targeted nursing care was carried out for patients at high risk and very high risk of deep venous thrombosis.All 56 patients who were underwent laparoscopic pelvic surgery from January 2015 to December 2016 were retrospectively collected as the control group.The incidence of deep vein thrombosis and other clinic indicators were observed between the two groups.Results The operation was successful in all patients.There was no significant difference in the blood loss and operation time between two groups.The postoperative continuous bed time,anal exhaust time,indwelling drainage tube time and hospital stay in the study group were all shorter than the control group,and there were significant differences.There were two cases of venous thrombosis of lower limbs in the study group and 6 cases in the control group.The incidence of deep venous thrombosis was statistically different between the two groups(P=0.032),and no pulmonary embolism occurred in the two groups.Conclusion The concept of ERAS and targeted nursing can reduce the occurrence of symptomatic venous thrombosis after laparoscopic pelvic surgery.

关 键 词：快速康复外科 深静脉血栓 腹腔镜 盆腔手术 护理 

分 类 号：R473.6[医药卫生—护理学]