| 摘要: |
| 目的:评价基于中医特色快速康复外科理念探讨腹腔镜胆囊切除术围手术期护理的干预效果。方法:选2018 年7 月—2019 年6 月期间本院肝胆科收治的行腹腔镜胆囊切除术的胆囊结石或胆囊息肉患者120 例，随机分成3 组，最后完成治疗及随访者114 例，其中观察组37 例(基于中医特色快速康复外科护理)，对照1 组38 例(传统常规护理)，对照2组39 例(快速康复外科护理)。比较3 组患者术前30 min 口渴情况，术后首次下床活动时间，术后首次排气时间，术后住院天数及术后相关并发症情况，检验并比较3 组术前1 天、术后第2 天的血清C 反应蛋白(CRP)及白细胞介素-6(IL-6)水平。结果:患者术前总口渴率观察组10.81%，对照2 组7.69%，均低于对照1 组的31.58% ；观察组患者首次排气时间(23.32±7.47) h、术后住院天数(2.31±1.03) d，少于对照1 组(31.95±10.38) h、(3.71±1.93) d，及对照2 组(27.21±8.56) h、(2.86±1.26) d，观察组首次下床活动时间(6.52±1.24) h，对照2 组(6.87±1.91) h，均早于对照1 组(11.65±5.78) h。术后观察组患者CRP(19.21±7.76) mg/L，IL-6(11.39±2.76) pg/mL，均低于对照1 组(28.36±11.35) mg/L、(15.49±5.77)pg/mL，及对照2 组(23.12±8.35) mg/L、(13.01±3.98) pg/mL。3 组患者术后胆漏、穿刺处皮下出血或感染、腹腔感染等术后并发症差异均无统计学意义(P >0.05)。结论:基于中医特色快速康复外科理念的腹腔镜胆囊切除术围手术期护理干预，提高患者围手术期舒适度，加快术后恢复，具有一定的临床应用价值。 |
| 关键词: 中医护理 快速康复外科 腹腔镜胆囊切除术 围手术期 |
| DOI：10.3969/j.issn.1007-6948.2020.06.013 |
| 投稿时间：2019-12-25 |
| 基金项目:浙江省嘉兴市科技局课题(2018AD32132) |
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| Discussion on Perioperative Nursing Intervention Effect of Laparoscopic Cholecystectomy Based on the Concept of Rapid Rehabilitation Surgery of Traditional Chinese Medicine |
| SHEN Li-dong,JIN Hui-ming,ZHU Xiao-ping |
| Department of Hepatology, Jiaxing Traditional Chinese Medicine Affiliated Hospital of Zhejiang Chinese Medicine University, Jiaxing 314000, China |
| Abstract: |
| Objective Analysis and evaluation of perioperative nursing intervention effect of laparoscopic cholecystectomy (LC) based on the concept of rapid rehabilitation surgery of traditional Chinese medicine.Methods 120 patients with LC who were admitted to our hospital from July 2018 to June 2019 were randomly divided into three groups. 114 patients were completed, including 37 patients in the observation group (based on the rapid rehabilitation surgery of traditional Chinese medicine) and the control group. One group of 38 cases(traditional routine care), the control group of 2 groups of 39 cases (rapid rehabilitation surgery). The thirst of the three groups before surgery, the time of first time to get out of bed after surgery, the first exhaust time after surgery, the number of postoperative hospital stays and postoperative complications were compared.Meanwhile,the 1st day before surgery and the CRP and IL-6 levels of the 2nd day after surgery were also checked and compared. Results The preoperative total thirst rate was 10.81% in the observation group and 7.69% in the control group 2, which was lower than 31.58% of the control group 1. The first exhaust time (23.32±7.47) hand the postoperative hospital stay (2.31±1.03) d in the observation groupwere less than those of the control group 1 (31.95±10.38) h, (3.71±1.93) d and the control group 2 (27.21±8.56) h, (2.86±1.26)d.The first time to get out of bed to observe the group of patients (6.52±1.24) h, control group 2(6.87±1.91) h were earlier than the control group 1 (11.65±5.78) h. The postoperative observation group had CRP (19.21±7.76) mg/L and IL-6 (11.39±2.76) pg/mL, which were lower than those of the control group 1 (28.36±11.35) mg/L, (15.49±5.77) pg/mL, and control group 2 (23.12±8.35) mg/L, (13.01±3.98) pg/ mL. There were no significant differences in postoperative complications between postoperative bile leakage, subcutaneous hemorrhage or infection and abdominal infection in the three groups (P>0.05). Conclusion The perioperative nursing intervention of laparoscopic cholecystectomy based on the concept of rapid rehabilitation surgery of traditional Chinese medicine has improved the perioperative comfort of patients and accelerated postoperative recovery, which has certain application value. |
| Key words: Chinese medicine nursing rapid rehabilitation surgery laparoscopic cholecystectomy perioperative period |
