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目的探讨快速康复外科(fast-track surgery,FTS)理念在老年肝外胆管结石患者腹腔镜围术期护理中的应用价值。方法选取2013年1月—2016年5月收入的肝外胆管结石老年患者102例,按照入院先后顺序分为对照组和观察组,各51例。两组均采用常规围术期护理,观察组增加FTS理念。观察两组术后并发症发生率及康复情况;比较两组对护理工作满意度情况。计量资料用比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组术后并发症发生率(3.92%)低于对照组(13.73%),差异有统计学意义(P<0.05)。观察组术后疼痛时间、排气时间、进食时间、拔除尿管时间、首次下床活动时间、自理能力恢复时间、住院时间[(4.22±0.68)h、(0.42±0.18)d、(6.15±0.21)h、(2.38±0.46)h、(12.34±1.09)h、(8.17±1.54)d、(8.59±1.33)d]均短于对照组[(12.38±2.79)h、(1.33±0.59)d、(12.36±0.60)h、(6.87±1.07)h、(48.52±2.24)h、(15.69±2.83)d、(16.24±2.51)d],差异有统计学意义(均P<0.05)。观察组护理满意度(98.04%)高于对照组(84.31%),差异有统计学意义(P<0.05)。结论快速康复外科理念可明显提升老年肝外胆管结石患者腹腔镜围术期护理效果,促进患者机体功能恢复,提高护理满意度。
Objective To investigate the value of fast-track surgery (FTS) in the management of elderly patients with extrahepatic bile duct stones underwent laparoscopic perioperative nursing. Methods A total of 102 elderly patients with extrahepatic bile duct stones from January 2013 to May 2016 were selected and divided into control group and observation group according to the sequence of hospital admission, with 51 cases in each group. Conventional perioperative nursing was used in both groups and FTS concept was added in the observation group. Observe the incidence of postoperative complications and rehabilitation in the two groups; compare the two groups satisfaction with nursing work. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The incidence of postoperative complications in observation group (3.92%) was lower than that in control group (13.73%), the difference was statistically significant (P <0.05). Postoperative pain time, exhaust time, feeding time, catheter removal time, time to first bed activity, self-care ability recovery time, hospital stay [(4.22 ± 0.68) h, (0.42 ± 0.18) (12.34 ± 1.09) h, (8.17 ± 1.54) d, (8.59 ± 1.33) d] were significantly shorter than those in the control group [(12.38 ± 2.79) h, (1.33 ± 0.59) d, (12.36 ± 0.60) h, (6.87 ± 1.07) h, (48.52 ± 2.24) h, (15.69 ± 2.83) d, (16.24 ± 2.51) d respectively. The difference was statistically significant (all P <0.05). The nursing satisfaction (98.04%) in the observation group was higher than that in the control group (84.31%), the difference was statistically significant (P <0.05). Conclusion The concept of rapid rehabilitation surgery can significantly improve the effect of laparoscopic perioperative nursing care in elderly patients with extrahepatic bile duct stones, promote the recovery of patients’ body function and improve the satisfaction of nursing.