线下模拟联合线上教育的早期运动对妇科腔镜手术二氧化碳气腹后遗效应的影响  

Effect of early exercise therapy based on offline simulation and online education on CO_(2) pneumoperitoneum after-effect of gynecological laparoscopic surgery

作　　者：陶小燕 郑叶平 高苏楠 陶开蓉 路建 Tao Xiaoyan;Zheng Yeping;Gao Sunan;Tao Kairong;Lu Jian(Department of Gynecology,The Second Hospital of Jiaxing,Jiaxing 314000,China)

机构地区：[1]嘉兴市第二医院妇科,浙江嘉兴314000 [2]嘉兴市第二医院护理部,浙江嘉兴314000 [3]嘉兴市第二医院麻醉科,浙江嘉兴314000

出　　处：《护理学杂志》2022年第12期22-25,共4页Journal of Nursing Science

基　　金：浙江省医药卫生科研基金项目(2020KY314);嘉兴市科技计划项目(2019AD32108);嘉兴市护理学创新学科建设计划资助项目(2019-SC-013)。

摘　　要：目的探讨线下模拟联合线上教育的早期运动疗法对妇科腹腔镜手术二氧化碳气腹后遗效应的影响。方法将124例择期全麻下行妇科腹腔镜手术的患者按时间段分为对照组和观察组各62例。对照组采用常规沟通宣教早期运动,按“理论讲解-模拟示教-对照练习”的模式进行;观察组采用线下模拟联合线上教育的早期运动,即按CICARE沟通模式建立腹腔镜手术早期运动的沟通服务流程,同时依托“互联网+”教育行早期运动疗法。记录术后患者对运动疗法的依从情况,肩痛、腹胀发生情况等。结果观察组术后不同时间运动疗法依从性显著优于对照组,肩痛、腹胀程度及术后48 h内肩痛、腹胀发生率显著低于对照组(P<0.05,P<0.01);观察组术后首次排气、排便、下床时间显著短于对照组(均P<0.01)。结论线下模拟联合线上教育的早期运动可提高患者对运动疗法的依从性,降低二氧化碳气腹后遗效应的发生率,促进术后快速康复。Objective To investigate the effect of early exercise therapy based on offline simulation and online education on CO_(2) pneumoperitoneum after-effect of gynecological laparoscopic surgery.Methods A total of 124 patients undergoing elective gynecological laparoscopic surgery under general anesthesia were divided into a control group and an intervention group,with 62 cases in each groups.The control group was subjected to early exercise therapy based on routine communication and education in the form of"explanation-demonstration teaching-exercise".The intervention group was subjected to early exercise therapy based on offline simulation and online education:CICARE communication mode was used to established the communication service process of early exercise therapy in laparoscopic surgery,and early exercise therapy was implemented relying on"Internet+"education.Patient adherence to exercise therapy,and the incidence of shoulder pain and abdominal distension were documented.Results Adherence to exercise therapy in the intervention group at varied time points was significantly better than in the control group;the scores of shoulder pain and abdominal distension,and the incidence rates of shoulder pain and abdominal distension within 48 h after surgery in the intervention group were significantly lower than those in the control group(P<0.05,P<0.01).The time to first passage of flatus,and first bowel movement,and the time to get off bed in the intervention group were significantly shorter than those in the control group(P<0.01 for all).Conclusion Early exercise therapy based on offline simulation and online education could improve patients′adherence to exercise therapy,reduce the incidence rates of CO_(2) pneumoperitoneum after-effect,and promote rapid recovery after surgery.

关 键 词：妇科 腹腔镜 二氧化碳气腹后遗效应 CICARE 六步流程沟通 “互联网+”护理 运动疗法 

分 类 号：R473.71[医药卫生—护理学]