ERAS在腹腔镜下胆总管一期缝合高龄患者中的护理应用  

Nursing Application of ERAS in Elderly Patients with Primary Suture of Common Bile Duct under Laparoscope

作　　者：罗芬[1] 林雪琴[1] 王洪超[1] LUO Fen;LIN Xueqin;WANG Hongchao(The Second Affiliated Hospital of Nanchang University,Nanchang 330000,China;不详)

机构地区：[1]南昌大学第二附属医院,江西南昌330000

出　　处：《中国医学创新》2022年第23期97-101,共5页Medical Innovation of China

基　　金：江西省卫生计生委科技计划项目(20195257)。

摘　　要：目的:探讨加速康复外科(ERAS)在腹腔镜下胆总管一期缝合高龄患者中的护理应用效果。方法:选择2019年1月-2021年1月于南昌大学第二附属医院就诊的腹腔镜下胆总管一期缝合的老年患者(≥75岁)60例作为对象,采用随机数字表法分为两组,各30例。对照组采用常规方法护理,观察组采用ERAS护理。护理2周后评估两组效果,并对患者进行30 d随访,比较两组术后恢复指标、住院费用、自我效能、术后并发症发生率、出院30 d内再入院率及满意度。结果:观察组术后首次排气、术后住院、术后进食、术后下床活动时间均短于对照组(P<0.05);护理2周后,两组自我技能、自护责任感、自我概念、健康知识评分较护理前均改善,且观察组均高于对照组(P<0.05)。观察组围手术期腹腔感染、胆漏及应激性溃疡发生率与出院30 d内再入院率均低于对照组(P<0.05);观察组护理2周后满意度高于对照组(P<0.05)。结论:ERAS用于腹腔镜下胆总管一期缝合高龄患者中,能缩短术后恢复时间,减少住院费用,有助于提升患者自我效能水平,降低术后并发症发生率及出院30 d内再住院率,可获得较高的护理满意度,值得推广应用。Objective:To explore the nursing effect of enhanced recovery after surgery(ERAS)in elderly patients with primary suture of common bile duct under laparoscopic.Method:A total of 60 elderly patients(≥75 years old)with primary suture of common bile duct under laparoscopy in the Second Affiliated Hospital of Nanchang University from January 2019 to January 2021 were selected as the subjects and divided into two groups by random number table method,30 cases in each group.The control group was given routine nursing care,while the observation group received ERAS nursing.The effects of two groups were evaluated after 2 weeks of nursing,and the patients were followed up for 30 d,the postoperative recovery indicators,hospitalization costs,self-efficacy,incidence of postoperative complications,readmission rate within 30 d after discharge and satisfaction were compared between the two groups.Result:The time of first postoperative exhaust,postoperative hospitalization,postoperative eating and postoperative ambulation in the observation group were shorter than those in the control group(P<0.05).After 2 weeks of nursing,the scores of self-skill,self-care responsibility,self-concept and health knowledge of two groups were higher than those before of nursing,and the observation group were higher than those of the control group(P<0.05).The incidence of perioperative abdominal infection,bile leakage and stress ulcer and the readmission rate within 30 d of discharge in the observation group were lower than those in the control group(P<0.05);the satisfaction of the observation group after 2 weeks of nursing was higher than that of the control group(P<0.05).Conclusion:ERAS in elderly patients with primary suture of common bile duct under laparoscopic can shorten postoperative recovery time,reduce hospitalization costs,improve patients’self-efficacy level,reduce postoperative complications and 30 d readmission rate after discharge,the nursing satisfaction is higher,it’s worthy of promotion and application.

关 键 词：加速康复外科 腹腔镜 胆总管一期缝合 高龄患者 自我效能 

分 类 号：R473.6[医药卫生—护理学]