加速康复外科理念在腹腔镜胆总管切开取石术一期缝合围手术期护理中的应用  

Application of enhanced recovery after surgery concept in perioperative nursing of laparoscopic choledocholithotomy and primary suture

作　　者：张慎雅 夏静[1] 陆贤 汤雪琴 ZHANG Shenya;XIA Jing;LU Xian;TANG Xueqin(General Surgery Department of Kunshan Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu Kunshan 215300,China)

机构地区：[1]南京中医药大学附属昆山市中医医院肝胆外科,江苏昆山215300

出　　处：《临床普外科电子杂志》2023年第4期37-40,共4页Journal of General Surgery for Clinicians(Electronic Version)

基　　金：江苏省“双创博士”人才项目[(2019)30393]。

摘　　要：目的 探究加速康复外科(enhanced recovery after surgery,ERAS)理念在腹腔镜胆总管切开取石术一期缝合围手术期护理中的应用效果。方法 回顾性分析2019年10月至2023年6月南京中医药大学附属昆山市中医医院收治的60例胆总管结石合并胆囊结石患者的临床资料,根据护理理念不同分为加速康复组(ERAS组)和传统护理方法组(对照组),每组各30例。对照组按照围手术期常规护理方案,ERAS组在常规护理的基础上,联合心理干预、围手术期营养支持以及中医药治疗,观察并比较两组患者手术相关指标及术后并发症情况。结果 ERAS组患者的术后肛门排气时间、排便时间、术后腹腔引流时间以及住院时间明显短于对照组(P <0.05);ERAS组患者术后刀口疼痛评分更低(P <0.05)。ERAS组患者术后并发症发生率为10.0%(3/30),略低于对照组患者的16.7%(5/30),差异无显著性(P> 0.05)。结论腹腔镜胆总管切开取石术一期缝合围手术期采用ERAS理念护理有效性和安全性高,可促进患者术后胃肠功能恢复,缩短引流管留置时间、缩短住院时间。Objective To explore the application effect of enhanced recovery after surgery(ERAS) concept in the perioperative nursing of laparoscopic choledocholithotomy and primary suture.Method The clinical data of 60 patients with common bile duct stones and gallbladder stones admitted to Kunshan Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from October 2019 to June 2023 were retrospectively analyzed.According to different nursing concepts,they are divided into an accelerated rehabilitation group(ERAS group) and a traditional nursing method group(control group),with 30 cases in each group.The control group was in accordance with the perioperative routine nursing plan,while the ERAS group was combined with psychological intervention,perioperative nutritional supporting,and traditional Chinese medicine therapy based on routine nursing.The operation-related indexes and postoperative complications of the two groups were observed and compared.Result The postoperative anal exhaust time,defecation time,postoperative abdominal drainage time and hospital stay in ERAS group were significantly shorter than those in control group(P < 0.05).The postoperative incision pain score was lower in the ERAS group(P < 0.05).The incidence of postoperative complications in the ERAS group was 10.0%(3/30),which was slightly lower than 16.7%(5/30) in the control group,there was no difference between two groups(P > 0.05).Conclusion The application of ERAS concept nursing in the perioperative period of laparoscopic common bile duct lithotomy and primary suture is effective and safe,which can accelerate the recovery of postoperative gastrointestinal function,reduce the time of drainage tube indwelling and shorten the length of hospital stay.

关 键 词：加速康复外科 围手术期 胆囊结石 胆总管结石 腹腔镜胆总管切开取石术 一期缝合 

分 类 号：R47[医药卫生—护理学]