腹腔镜下胆囊切除术联合精细化流程管理对早期胆囊癌凝血指标的影响  

The Effect of Laparoscopic Cholecystectomy Combined with Refined Process Management on Coagulation Indicators in Early Gallbladder Cancer Patients

作　　者：李亚慧 高新颖 LI Ya-hui;GAO Xin-ying(Department of Gastroenterology,Hepatology and Biliary,Shangqiu First People's Hospital,Shangqiu 476100,Henan Province,China)

机构地区：[1]商丘市第一人民医院胃肠肝胆一科,河南商丘476100

出　　处：《罕少疾病杂志》2025年第2期100-102,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨腹腔镜下胆囊切除术联合精细化流程管理对早期胆囊癌患者凝血指标的影响。方法 选择78例早期胆囊癌患者,均来源于商丘市第一人民医院,将其分为对照组(39例,常规管理干预措施)和研究组(39例,精细化流程管理)。两组患者均行腹腔镜下胆囊切除术治疗。对比两组患者手术指标,术前、术后24 h凝血功能指标,干预前后心理状况评分,手术室管理质量评分,以及管理工作效率。结果 研究组患者首次排气时间、首次下床时间、术后住院时间均比对照组缩短(均P<0.05);术后24h两组患者APTT、PT、TT水平均下降,FIB、D-D均上升(均P<0.05),但术后24h两组患者上述指标对比,无明显差异(均P>0.05);干预后两组患者SAS、SDS评分均比干预前下降,且研究组比对照组低(均P<0.05);研究组患者管理技能、管理记录、卫生消毒等评分均比对照组高(均P<0.05);研究组患者术前准备时间、接送患者时间均比对照组短(均P<0.05)。结论 腹腔镜下胆囊切除术联合精细化流程管理应用于早期胆囊癌患者中,可缩短患者首次排气时间与下床时间,促进患者早日恢复,对凝血功能的影响较小,缓解负性情绪,提高手术室管理工作效率。Objective To investigate the effect of laparoscopic cholecystectomy combined with refined procedure management on coagulation index of early gallbladder cancer patients.Methods 78 patients with early gallbladder cancer were selected from Shangqiu First People's Hospital and divided into control group(39 cases,routine management intervention measures)and study group(39 cases,refined process management).Both groups underwent laparoscopic cholecystectomy.Surgical indexes,coagulation function indexes before and 24 h after the intervention,psychological status scores before and after the intervention,operating room management quality scores,and management efficiency were compared between the two groups.Results The first exhaust time,first bedtime,and postoperative hospitalization time of the study group patients were shorter than those of the control group(all P<0.05).At 24 hours after surgery,the levels of APTT,PT,and TT in both groups of patients decreased,while FIB and D-D increased(all P<0.05).However,there was no significant difference in the above indicators between the two groups of patients at 24 hours after surgery(all P>0.05).After intervention,the SAS and SDS scores of both groups of patients decreased compared to before intervention,and the study group was lower than the control group(both P<0.05).The scores of management skills,management records,hygiene and disinfection in the study group were higher than those in the control group(all P<0.05).The preoperative preparation time and pick-up time for patients in the study group were shorter than those in the control group(all P<0.05).Conclusion The application of laparoscopic cholecystectomy combined with refined process management in early stage gallbladder cancer patients can shorten the first exhaust time and bedtime of patients,promote early recovery,have less impact on coagulation function,alleviate negative emotions,and improve the efficiency of operating room management.

关 键 词：腹腔镜下胆囊切除术 精细化流程管理 早期胆囊癌 凝血指标 

分 类 号：R657.4[医药卫生—外科学]