基于加速康复外科理念的护理干预在腹腔镜胆囊切除术患者围手术期的应用效果  

Application effect of nursing intervention based on the concept of enhanced recovery after surgery in perioperative period of laparoscopic cholecystectomy patients

作　　者：烟晓丽 姚利[1] 杨翔 刘海平[1] YAN Xiaoli;YAO Li;YANG Xiang;LIU Haiping(Operating Room,Handan Central Hospital,Hebei Province,Handan056008,China)

机构地区：[1]河北省邯郸市中心医院手术室,河北邯郸056008

出　　处：《中国医药导报》2024年第8期166-170,共5页China Medical Herald

基　　金：河北省卫生健康委员会医学科学研究项目(20191864)。

摘　　要：目的 探讨基于加速康复外科(ERAS)理念的护理干预在腹腔镜胆囊切除术(LC)患者围手术期的应用效果。方法 选取2021年1月至2022年3月河北省邯郸市中心医院接受LC治疗的100例患者为研究对象,采用随机数字表法将其分为常规组和干预组,各50例。常规组实施常规围手术期护理,干预组在常规组的基础上行ERAS理念下围手术期护理。观察并比较两组应激反应指标水平变化、术后疼痛程度、并发症发生情况及患者术后康复速度。结果 术后24 h,两组皮质醇、肾上腺素水平均高于术前1 h,且干预组术前1 h、术后24 h时指标水平低于常规组,差异有统计学意义(P<0.05);干预组术后视觉模拟评分法评分、并发症总发生率低于常规组,差异有统计学意义(P<0.05);干预组术后首次下床、肛门首次排气、首次排便、停止输液及住院时间均短于常规组,差异有统计学意义(P<0.05)。结论 基于ERAS理念围手术期干预模式用于LC治疗患者,可避免患者出现强烈应激反应,缓解疼痛感,预防并发症发生,缩短患者术后康复时间。Objective To explore application effect of nursing intervention based on the concept of enhanced recovery after surgery(ERAS)in perioperative period of laparoscopic cholecystectomy(LC)patients.Methods A total of 100 patients who received LC in Handan Central Hospital,Hebei Province from January 2021 to March 2022 were selected as the study objects.They were divided into routine group and intervention group by random number table method,with 50 cases in each group.The routine group received routine perioperative nursing,and the intervention group received perioperative nursing under the ERAS concept based on the conventional group.The changes of stress response indexes,postoperative pain,complications and postoperative recovery speed were observed and compared between the two groups.Results Twenty-four hours after surgery,the levels of cortisol and adrenaline in both groups were higher than those 1 h before surgery,and the two indexes in the intervention group were lower than those in the routine group 1 h before surgery and 24 h after surgery,and the differences were statistically significant(P<0.05).The score of visual analog scoring and the total complication rate of the intervention group were lower than those of the routine group,and the differences were statistically significant(P<0.05).After surgery,the time of first getting out of bed,first anal exhaust,first defecation,stopping infusion,and hospitalization in the intervention group were shorter than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion Perioperative intervention mode based on ERAS concept can avoid strong stress reaction,relieve pain,prevent complications and shorten postoperative rehabilitation time for patients treated with LC.

关 键 词：腹腔镜胆囊切除术 围手术期护理 快速康复理念 应激反应 疼痛 

分 类 号：R473[医药卫生—护理学]