基于加速康复外科理念的集束化干预在腹腔镜胆囊切除患者围术期护理中的应用  

Application of care bundles based on the concept of enhanced recovery after surgery in perioperative nursing of patients undergoing laparoscopic cholecystectomy

作　　者：房树恒 朱恒美 董志涛 贺丹丹 FANG Shuheng;ZHU Hengmei;DONG Zhitao;HE Dandan(Department of Anesthesiology,Third Affiliated Hospital of Naval Medical University,Shanghai,200438;Special Treatment Clinic,Third Affiliated Hospital of Naval Medical University,Shanghai,200438;Sixth Department of Liver Surgery,Third Affiliated Hospital of Naval Medical University,Shanghai,200438)

机构地区：[1]海军军医大学第三附属医院,东方肝胆外科医院麻醉科,上海200438 [2]海军军医大学第三附属医院,东方肝胆外科医院特需诊疗科,上海200438 [3]海军军医大学第三附属医院,东方肝胆外科医院肝外六科,上海200438

出　　处：《中西医结合护理》2024年第5期149-153,共5页Chinese Journal of Integrative Nursing

基　　金：2021年上海市“医苑新星”人才培养资助计划项目;海军军医大学第三附属医院军事培育课题(2021JSYX001);海军军医大学深蓝护理课题(2022KYG39);海军军医大学第三附属医院腾飞工程人才项目(202429)。

摘　　要：目的探讨基于加速康复外科理念的集束化干预措施在腹腔镜胆囊切除患者围术期护理中的应用效果。方法选取2021年1月—2023年1月某三甲肝胆专科医院收治的260例行腹腔镜胆囊切除术的患者为研究对象,随机分为两组:对照组(n=130)围手术期间给予常规护理;观察组(n=130)实施基于加速康复外科理念的集束化干预措施。比较两组术后恢复情况、并发症发生率以及术后疼痛情况。结果术后2 h、6 h、24 h观察组患者疼痛视觉模拟(VAS)评分低于对照组,差异有统计学意义(P<0.05)。与对照组相比,观察组患者术后排气时间、下床时间和住院天数均缩短,差异有统计学意义(P<0.05)。对照组呕吐、切口感染与胆漏发生率高于观察组,差异有统计学意义(P<0.05)。结论基于加速康复外科理念的集束化干预措更有利于患者术后康复,提高术后生活质量。Objective To investigate the effect of care bundles based on the concept of en-hanced recovery after surgery in perioperative nursing of patients undergoing laparoscopic chole-cystectomy.Methods A total of 260 cases of laparoscopic cholecystectomy were randomly divid-ed into observation group(n=130,received routine nursing care)and control group(n=130,re-ceived care bundles based on the concept of enhanced recovery).Postoperative recovery condi-tion,incidence of complications and postoperative pain were compared between the two groups.Results At 2,6 and 24 h after surgery,the Visual Analogue Scale of pain in the observation group were lower than those in the control group,with a significant difference(P<0.05).The time to first postoperative exhaustion,time to off-bed activities and hospital stays in the observa-tion group were shorter than those in the control group(P<0.05).The incidence of vomiting,in-cision infection,and bile leakage in the control group was significantly higher than that in the ob-servation group,with a significant difference(P<0.05).Conclusion The application of care bundles based on the concept of enhanced recovery after surgery are conducive to the postopera-tive recovery of patients undergoing laparoscopic cholecystectomy,as well as the improvement of postoperative quality of life.

关 键 词：集束化护理 加速康复外科 腹腔镜胆囊切除术 围手术期护理 

分 类 号：R473.6[医药卫生—护理学]