快速康复外科在腹腔镜胆囊手术疼痛管理中的应用分析
|
摘要
目的探讨快速康复外科(FTS)在腹腔镜胆囊手术疼痛管理中的应用价值。方法将120例接受腹腔镜胆囊切除术患者作为研究对象,随机分为观察组和对照组,每组60例。观察组行FTS护理,对照组行常规护理。记录两组术后肛门排气时间、下床时间、输液量及进流质饮食时间,比较两组VAS疼痛评分及疼痛严重程度。结果观察组术后1 d、3 d及1周时VAS评分均显著低于术前1 d和对照组差异均有统计学意义(P<0.05)。观察组术后疼痛程度低于对照组,差异有统计学意义(P<0.05)。观察组术后肛门首次排气时间、下床时间、输液量、进流质饮食时间及术后并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论 FTS用于腹腔镜胆囊手术术后护理能迅速改善疼痛症状,减轻疼痛程度,且有助于患者胃肠功能恢复,缩短康复时间。
Objective To investigate the application value of fast track surgery( FTS) in the pain management of laparoscopic gallbladder surgery. Methods A total 120 patients underwent laparoscopic cholecystectomy were randomly divided into observation group and control group,60 cases in each group. The observation group received FTS nursing,and the control group received routine nursing care. The postoperative anal exhaust time,bed time,transfusion volume and the time of liquid feeding were recorded,and the VAS scores and pain degrees were compared. Results The VAS scores of the observation group in 1 day,3 days and 1 weeks after operation were significantly lower than those before operation and those of the control group in the same time( P < 0. 05). The degrees of postoperative pain in the observation group were significantly lower than those in the control group( P < 0. 05). The postoperative anal exhaust time,bed time,the amount of infusion,the time of feeding and the incidence of postoperative complications in the observation group were significantly shorter than those in the control group( P < 0. 05). Conclusion FTS can rapidly improve the symptoms of pain after laparoscopic cholecystectomy,and it contribute to the recovery of gastrointestinal function and shorten the recovery time.
Objective To investigate the application value of fast track surgery( FTS) in the pain management of laparoscopic gallbladder surgery. Methods A total 120 patients underwent laparoscopic cholecystectomy were randomly divided into observation group and control group,60 cases in each group. The observation group received FTS nursing,and the control group received routine nursing care. The postoperative anal exhaust time,bed time,transfusion volume and the time of liquid feeding were recorded,and the VAS scores and pain degrees were compared. Results The VAS scores of the observation group in 1 day,3 days and 1 weeks after operation were significantly lower than those before operation and those of the control group in the same time( P < 0. 05). The degrees of postoperative pain in the observation group were significantly lower than those in the control group( P < 0. 05). The postoperative anal exhaust time,bed time,the amount of infusion,the time of feeding and the incidence of postoperative complications in the observation group were significantly shorter than those in the control group( P < 0. 05). Conclusion FTS can rapidly improve the symptoms of pain after laparoscopic cholecystectomy,and it contribute to the recovery of gastrointestinal function and shorten the recovery time.
引文
[1]董明杰,谈燚.腹腔镜胆囊切除术的手术类型研究进展[J].蚌埠医学院学报,2016,41(9):1256-1259.
[2]张延英.FTS在腹腔镜胆囊切除手术中的应用观察[J].海南医学院学报,2016,22(11):1101-1103.
[3]效小莉,陈醒,白文佩,等.妇科微创手术围术期疼痛管理的进展[J].中国疼痛医学杂志,2016,22(9):641-644.
[4]雍桂珍,兰长骏,甘宇业.疼痛护理对LASIK手术的疼痛及术后满意度的影响[J].实用医学杂志,2014,30(16):2663-2665.
[5]郑建伟,袁辉生,宋茂氏,等.快速康复外科理论在高龄患者腹腔镜胆囊切除术中的应用—前瞻性随机对照研究[J].中国微创外科杂志,2012,12(2):149-151.
[6]谢桂生,董保国,梁池,等.中西医结合快速康复流程在结直肠癌手术中的应用[J].微创医学,2016,11(4):576-578.
[7]王岩岩,文刚,何磊,等.快速康复外科理念在胃癌手术应用中的最新进展[J].山东医药,2013,53(17):96-98.
[8]单葵顺,邓晨晖.快速康复外科理念在手术室护理中的应用[J].广东医学,2014,35(4):637-639.
[9]豆欣蔓,杨丽.快速康复外科在腹腔镜胆囊切除术围手术期护理中的应用[J].中国微创外科杂志,2011,11(12):1121-1124.
[10]陈秋文,章育盛,张高耀.快速康复外科在结直肠手术围手术期中的应用[J].实用医学杂志,2013,29(6):967-969.
[11]范桂红,张丽艳,王桂梅,等.快速康复外科理念对老年胆囊手术患者术后康复的影响[J].中国老年学杂志,2013,33(15):3785-3787.
[12]张林颖,侯小娟,李琳,等.腹部外科大手术后患者体温变化及护理[J].解放军护理杂志,2011,28(24):20-23.
[13]张小红,何红燕,何红,等.快速康复外科护理对外科手术患者恢复效率及护理满意度的影响[J].实用临床医药杂志,2014,18(4):18-21.
[14]徐枫,杨承祥,邓硕曾.右美托咪啶在围术期临床应用的研究进展[J].国际麻醉学与复苏杂志,2011,32(3):336-340.
[15]王妍心,刘国泽.右美托嘧啶用于腰硬麻醉下妇科手术病人镇静的临床分析[J].现代预防医学,2012,39(10):2444-2446.
[16]周筠,郭穗霞,范晓军,等.小儿术后镇痛用药情况分析[J].广州医药,2008,39(6):36-38.
[2]张延英.FTS在腹腔镜胆囊切除手术中的应用观察[J].海南医学院学报,2016,22(11):1101-1103.
[3]效小莉,陈醒,白文佩,等.妇科微创手术围术期疼痛管理的进展[J].中国疼痛医学杂志,2016,22(9):641-644.
[4]雍桂珍,兰长骏,甘宇业.疼痛护理对LASIK手术的疼痛及术后满意度的影响[J].实用医学杂志,2014,30(16):2663-2665.
[5]郑建伟,袁辉生,宋茂氏,等.快速康复外科理论在高龄患者腹腔镜胆囊切除术中的应用—前瞻性随机对照研究[J].中国微创外科杂志,2012,12(2):149-151.
[6]谢桂生,董保国,梁池,等.中西医结合快速康复流程在结直肠癌手术中的应用[J].微创医学,2016,11(4):576-578.
[7]王岩岩,文刚,何磊,等.快速康复外科理念在胃癌手术应用中的最新进展[J].山东医药,2013,53(17):96-98.
[8]单葵顺,邓晨晖.快速康复外科理念在手术室护理中的应用[J].广东医学,2014,35(4):637-639.
[9]豆欣蔓,杨丽.快速康复外科在腹腔镜胆囊切除术围手术期护理中的应用[J].中国微创外科杂志,2011,11(12):1121-1124.
[10]陈秋文,章育盛,张高耀.快速康复外科在结直肠手术围手术期中的应用[J].实用医学杂志,2013,29(6):967-969.
[11]范桂红,张丽艳,王桂梅,等.快速康复外科理念对老年胆囊手术患者术后康复的影响[J].中国老年学杂志,2013,33(15):3785-3787.
[12]张林颖,侯小娟,李琳,等.腹部外科大手术后患者体温变化及护理[J].解放军护理杂志,2011,28(24):20-23.
[13]张小红,何红燕,何红,等.快速康复外科护理对外科手术患者恢复效率及护理满意度的影响[J].实用临床医药杂志,2014,18(4):18-21.
[14]徐枫,杨承祥,邓硕曾.右美托咪啶在围术期临床应用的研究进展[J].国际麻醉学与复苏杂志,2011,32(3):336-340.
[15]王妍心,刘国泽.右美托嘧啶用于腰硬麻醉下妇科手术病人镇静的临床分析[J].现代预防医学,2012,39(10):2444-2446.
[16]周筠,郭穗霞,范晓军,等.小儿术后镇痛用药情况分析[J].广州医药,2008,39(6):36-38.