快速康复外科对高龄腹腔镜子宫切除患者心理负担、手术恢复情况及预后的影响  

The effect of fast track surgery on the psychological burden, surgical recovery and prognosis of elderly patients undergoing laparoscopic hysterectomy

作　　者：朱静 邵长好 孙滨州 Zhu Jing;Shao Changhao;Sun Binzhou(Department of Gynecology,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao Hebei 066000,P.R.China)

机构地区：[1]秦皇岛市妇幼保健院妇科,河北秦皇岛0660000

出　　处：《中国计划生育和妇产科》2022年第12期72-76,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：秦皇岛市科技支撑计划项目(项目编号:20191391)。

摘　　要：目的 探讨快速康复外科(fast track surgery, FTS)对高龄腹腔镜子宫切除患者心理负担、手术恢复情况及预后的影响。方法 选取2018年7月至2020年7月秦皇岛市妇幼保健院116例高龄腹腔镜子宫切除患者,根据建档顺序分组,各58例,对照组给予传统围术期干预,观察组基于对照组给予FTS干预。统计两组干预前后心理负担(profilemoodstates, POMS)、手术恢复情况、术后镇痛、并发症发生率及术前、术后2 d炎性指标[C-反应蛋白(C-reactive protein, CRP)、白细胞(white blood cell, WBC)、中性粒细胞]变化。结果 观察组术中出血量低于对照组,手术、排气、下地活动及住院时间短于对照组(P<0.05);干预后观察组POMS评分低于对照组(P<0.05);术后2 h、6 h观察组疼痛视觉模拟量表(visual analogue scale, VAS)评分低于对照组(P<0.05);观察组并发症发生率(3.45%)低于对照组(17.24%)(P<0.05);术后2 d两组CRP、WBC、中性粒细胞水平均较术前升高,但观察组低于对照组,差异均有统计学意义(P<0.05)。结论 高龄腹腔镜子宫切除患者围术期管理中,FTS能减轻患者心理负担,改良机体内环境,促进术后康复,改善预后,缩短住院时间。Objective To investigate the effect of fast track surgery(FTS) on the psychological burden, surgical recovery and prognosis of elderly patients with laparoscopic hysterectomy.Methods 116 elderly patients with laparoscopic hysterectomy in Qinhuangdao Maternal and Child Health Hospital from July 2018 to July 2020 were selected and divided into groups according to the filing order, with 58 cases in each group.The control group was given traditional perioperative intervention, and the observation group was given FTS intervention based on the control group.The changes of psychological burden(POMS),surgical recovery, postoperative analgesia, incidence of complications and inflammatory indexes [C-reactive protein(CRP),white blood cell(WBC) and neutrophil] before and 2 days after intervention were counted.Results The intraoperative blood loss of the observation group was lower than that of the control group, and the operation time, exhaust, ground activity and hospitalization time were shorter than those of the control group(P<0.05).After the intervention, the POMS scores of the observation group were lower than those in the control group(P<0.05).The visual analogue scale(VAS) score of the observation group was lower than that of the control group at 2 h and 6 h after operation(P<0.05).The complication rate in the observation group was 3.45% lower than 17.24% in the control group(P<0.05).The levels of CRP,WBC,and neutrophils at 2 days after operation in the two groups were higher than those before the operation, but the observation group was lower than the control group, the differences were statistically significant(P<0.05).Conclusion In the perioperative management of elderly patients with laparoscopic hysterectomy, FTS can reduce the psychological burden of patients, improve the internal environment, promote postoperative recovery, improve prognosis, and shorten the length of hospital stay.

关 键 词：快速康复外科 高龄 腹腔镜子宫切除 心理负担 

分 类 号：R713.42[医药卫生—妇产科学] R473.71[医药卫生—临床医学]