快速康复护理在单操作孔全胸腔镜下肺癌完全切除术后的应用
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摘要
目的探讨快速康复护理在单操作孔全胸腔镜下肺癌完全切除术后的应用效果。方法实验组采用快速康复外科的理念对2016年6月至2017年12月间的550例患者给予护理,对照组回顾性分析2014年9月至2016年5月间500例患者的护理方法。2组患者均行单操作孔全胸腔镜下肺癌完全切除术。结果 2组患者均手术顺利,无围手术期死亡病例,实验组的术后第一次下床活动时间、术后平均住院时间、平均拔管时间、首次排气时间均短于对照组(P <0.05),术后并发症发生75例显著低于对照组126例,护理满意度95.1%显著高于对照组91%(P <0.05)。结论单操作孔创伤小,手术时间,拔管时间短,对施行单操作孔全胸腔镜下肺癌完全切除术的患者实施快速康复护理措施,可以缩短住院时间,缩短第一次下床活动时间,减轻患者疼痛,提高护理满意度。
Objective To study the application effect of rapid rehabilitation nursing in patients after uniport video-assisted thoracoscopic complete resection of lung cancer.Methods The experimental group adopted the concept of rapid rehabilitation surgery to provide care to 550 patients between June 2016 and December 2017. The control group retrospectively analyzed the nursing methods of 500 patients between September 2014 and May 2016.Two groups of patients underwent single operation with total thoracoscopic lung cancer complete resection. Results All patients underwent operations successfully and there were no mortality occurred during the postoperative period.For the experimental group, the first time to get out of bed, average length of stay after surgery, average tube extraction time and first exhaust time were shorter than those of the control group(P < 0.05). The incidence of postoperative complications was significantly lower than that of the control group. 95.1% of the patients in the experimental group were very satisfied, significantly higher than the control group 91.0%(P < 0.05).Conclusion The rapid rehabilitation nursing measures for patients after completely uniport thoracoscopic lobectomy can shorten the average length of hospital stay, shorten the time of the first bed activity, alleviate the pain and improve the[A1] nursing satisfaction.
Objective To study the application effect of rapid rehabilitation nursing in patients after uniport video-assisted thoracoscopic complete resection of lung cancer.Methods The experimental group adopted the concept of rapid rehabilitation surgery to provide care to 550 patients between June 2016 and December 2017. The control group retrospectively analyzed the nursing methods of 500 patients between September 2014 and May 2016.Two groups of patients underwent single operation with total thoracoscopic lung cancer complete resection. Results All patients underwent operations successfully and there were no mortality occurred during the postoperative period.For the experimental group, the first time to get out of bed, average length of stay after surgery, average tube extraction time and first exhaust time were shorter than those of the control group(P < 0.05). The incidence of postoperative complications was significantly lower than that of the control group. 95.1% of the patients in the experimental group were very satisfied, significantly higher than the control group 91.0%(P < 0.05).Conclusion The rapid rehabilitation nursing measures for patients after completely uniport thoracoscopic lobectomy can shorten the average length of hospital stay, shorten the time of the first bed activity, alleviate the pain and improve the[A1] nursing satisfaction.
引文
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[11]赵光强,黄云超,陈小波,等.快速康复外科在肺癌手术中的应用研究[J].中国肺癌杂志,2010,13(02):102-106.
[12]云南省肿瘤医院.住院病人对优质护理服务体验满意度问卷[EB/OL].[2018-01-20].http://www.ynszlyy.com/QS/Release/MobileSurverAnswerOne.html?Answer ID=cb09f2bd-f68c-4663-8e4c-3e118c050285&Survey Instance ID=df305d5c-810a-474f-ac1d-b0a3487b242e
[13]陈颖,雷玉洁,黄云超,等.右侧非小细胞肺癌患者双肺叶切除与单肺叶切除术后并发症的比较[J].中国肺癌杂志,2014,17(08):596-600.
[14]李文洁.肺癌患者围术期并发症发生相关因素及护理对策分析[J].实用临床医药杂志,2015,19(22):64-66.
[15]黄俊,何家贤.肺癌手术治疗围术期肺并发症的危险因素分析[J].广西医科大学学报,2017,34(11):1608-1610.
[16]夏俊,于在诚,聂弘,等.合并慢性阻塞性肺疾病对老年肺癌患者术后并发症及预后的影响[J].中国老年学杂志,2015,35(11):3066-3067.
[17]李牧,宋剑非,梁岳培,等.肺癌患者应用快速康复外科治疗的安全性及有效性[J].中国康复医学杂志,2010,25(10):1005-1007.
[18]刘纯影,黄敏清,赵舜珍.选择不同拍背时机对肺叶切除术后患者排痰效果的影响[J].广东医学,2009,30(12):1936-1937.
[19]常健,沈慧丽,盛怡,王海.基于快速康复的日间手术护理质量探索[J].中国卫生质量管理,2018,25(04):22-24.
[20]李桂芩,杨大雍.快速康复外科护理在外科领域中的系统评价[J].锦州医科大学学报,2018,39(03):88-90.
[21]吴乾,郝跃峰,刘毅,杨卫新,管骏涛,袁振.全髋关节置换术后快速康复的研究进展[J].医学综述,2018,24(15):3023-3028.
[22]黄陈江.快速康复外科理念在胃肠外科的应用现状及发展前景[J].中外医疗,2018,37(15):193-195.
[23]高玲一,孔海红,李晓艳,等.肺癌患者肺叶切除术手术前后的常规护理和心理护理研究[J].中国现代医生,2017,55(13):150-153.
[2]刘妙.单操作孔电视胸腔镜肺叶切除围术期护理体会[J].齐齐哈尔医学院学报,2015,36(09):1389-1390.
[3]靳海荣.单操作孔电视胸腔镜手术的护理[J].军医进修学院学报,2010,31(11):1056-1057.
[4]黄云超,赵光强,雷玉洁,等.单操作孔全胸腔镜在34例肺癌完全切除术中的应用[J].云南医药,2014,35(06):624-627.
[5]陈柯宇,颜美琼.肺癌患者快速康复围术期护理进展[J].护士进修杂志,2017,32(02):120-123.
[6]袁凤辉.快速康复外科在肺癌肺叶切除术围手术期护理中的应用[J].职业与健康,2011,27(04):477-479.
[7]王建荣,张黎明,韩忠福,等.不同雾化吸入方案对肺切除病人术后痰液黏弹性的影响[J].中华护理杂志,2003,38(7):8-11.
[8]何浩,沙永生,孔轻轻.肺癌患者全肺切除术后并发心律失常的原因分析及护理对策[J].护士进修杂志,2013,28(11):1011-1014.
[9]黄霞.胸部叩击疗法对提高有效排痰率的护理[J].包头医学院学报,2015,31(09):106-107.
[10]郑惠萍,张杏玉,伍爱仪.快速康复理念在肺癌全肺切除术患者围手术期护理中的应用[J].护理实践与研究,2016,13(01):59-61.
[11]赵光强,黄云超,陈小波,等.快速康复外科在肺癌手术中的应用研究[J].中国肺癌杂志,2010,13(02):102-106.
[12]云南省肿瘤医院.住院病人对优质护理服务体验满意度问卷[EB/OL].[2018-01-20].http://www.ynszlyy.com/QS/Release/MobileSurverAnswerOne.html?Answer ID=cb09f2bd-f68c-4663-8e4c-3e118c050285&Survey Instance ID=df305d5c-810a-474f-ac1d-b0a3487b242e
[13]陈颖,雷玉洁,黄云超,等.右侧非小细胞肺癌患者双肺叶切除与单肺叶切除术后并发症的比较[J].中国肺癌杂志,2014,17(08):596-600.
[14]李文洁.肺癌患者围术期并发症发生相关因素及护理对策分析[J].实用临床医药杂志,2015,19(22):64-66.
[15]黄俊,何家贤.肺癌手术治疗围术期肺并发症的危险因素分析[J].广西医科大学学报,2017,34(11):1608-1610.
[16]夏俊,于在诚,聂弘,等.合并慢性阻塞性肺疾病对老年肺癌患者术后并发症及预后的影响[J].中国老年学杂志,2015,35(11):3066-3067.
[17]李牧,宋剑非,梁岳培,等.肺癌患者应用快速康复外科治疗的安全性及有效性[J].中国康复医学杂志,2010,25(10):1005-1007.
[18]刘纯影,黄敏清,赵舜珍.选择不同拍背时机对肺叶切除术后患者排痰效果的影响[J].广东医学,2009,30(12):1936-1937.
[19]常健,沈慧丽,盛怡,王海.基于快速康复的日间手术护理质量探索[J].中国卫生质量管理,2018,25(04):22-24.
[20]李桂芩,杨大雍.快速康复外科护理在外科领域中的系统评价[J].锦州医科大学学报,2018,39(03):88-90.
[21]吴乾,郝跃峰,刘毅,杨卫新,管骏涛,袁振.全髋关节置换术后快速康复的研究进展[J].医学综述,2018,24(15):3023-3028.
[22]黄陈江.快速康复外科理念在胃肠外科的应用现状及发展前景[J].中外医疗,2018,37(15):193-195.
[23]高玲一,孔海红,李晓艳,等.肺癌患者肺叶切除术手术前后的常规护理和心理护理研究[J].中国现代医生,2017,55(13):150-153.