快速康复外科护理对腹腔镜肾上腺手术患者应激反应及术后恢复的影响  

Effect of rapid rehabilitation surgical nursing on stress response and postoperative recovery of patients undergoing laparoscopic adrenal surgery

作　　者：郁晓红 陆彩萍 阚峰玉 YU Xiaohong;LU Caiping;KAN Fengyu(Operation Room,Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University,Suzhou Jiangsu 215153;Operation Room,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou Jiangsu 215001,China)

机构地区：[1]南京医科大学附属苏州科技城医院手术室,江苏苏州215153 [2]南京医科大学附属苏州医院手术室,江苏苏州215001

出　　处：《临床与病理杂志》2021年第12期2955-2960,共6页Journal of Clinical and Pathological Research

基　　金：南京医科大学附属苏州科技城医院院级课题(2021HL A001)。

摘　　要：目的:研究快速康复外科护理对不同腹腔镜肾上腺手术患者应激反应及术后恢复的影响。方法:选取2017年5月至2020年8月就诊的腹腔镜肾上腺手术患者70例,随机分为对照组与观察组,每组各35例。其中对照组予以常规护理,观察组在对照组的基础上予以快速康复外科护理,比较观察组与对照组围手术期指标、应激反应、术后恢复及术后并发症。结果:观察组围手术期指标手术时间、术中出血量、引流管滞留时间及引流量均显著低于对照组(均P<0.05)。术后10 min,观察组应激反应指标肾上腺素、去甲肾上腺素、皮质醇水平均显著低于对照组(均P<0.05)。术后观察组首次排气时间、肠胃功能恢复时间、下床活动时间、术后住院时间均显著低于对照组(均P<0.05)。术后观察组术后并发症总发生率显著低于对照组(P<0.05)。结论:快速康复外科护理对不同入路后腹腔镜肾上腺手术患者进行干预,能显著降低应激反应,加快术后恢复,减轻术后并发症,提高了临床治疗效果。Objective:To study the effect of rapid rehabilitation surgical nursing on stress response and postoperative recovery of patients undergoing different laparoscopic adrenal surgery.Methods:Seventy patients undergoing laparoscopic adrenalectomy from May 2017 to August 2020 were randomly divided into a control group and an observation group,with 35 cases in each group.The control group received routine nursing,while the observation group received rapid rehabilitation surgical nursing on the basis of the control group.Perioperative indicators,stress response,postoperative recovery and postoperative complications were compared between the observation group and the control group.Results:The perioperative indexes such as operation time,intraoperative blood loss,retention time of drainage tube and drainage volume in the observation group were significantly lower than those in the control group(P<0.05).The levels of epinephrine,norepinephrine,and cortisol in the observation group were significantly lower than those in the control group at the 10 th min after the operation.The first exhaust time,the recovery time of gastrointestinal function,the time of getting out of bed,and the time of hospitalization in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Rapid rehabilitation surgical nursing can significantly reduce stress reaction,accelerate postoperative recovery,reduce postoperative complications and improve clinical treatment effect of patients undergoing laparoscopic adrenal surgery after different approaches.

关 键 词：快速康复外科护理 腹腔镜肾上腺手术 应激反应 术后恢复 

分 类 号：R473.6[医药卫生—护理学]