快速康复外科护理对高龄腹腔镜胆囊切除术患者手术应激及术后恢复的影响

Effect of Rapid Rehabilitation Surgical Nursing on Operative Stress and Postoperative Recovery in Elderly Patients Undergoing Laparoscopic Cholecystectomy

摘要: 目的：探讨快速康复外科护理(fast track surgery, FTS)对腹腔镜胆囊切除术高龄患者手术应激反应和术后恢复的影响。方法：抽取本院2016年6月~2018年8月行腹腔镜胆囊切除术的高龄患者90例为研究样本，以随机序列软件奇偶数法分为参照组和干预组各45例，参照组采取常规围术期护理，干预组在上述基础上采取FTS护理。对比两组患者手术应激反应、术后恢复情况和并发症发生率。结果：干预组24 h Cor、FPG、IL-6、CRP、肾上腺素水平以及SAS、SDS评分、并发症发生率均低于参照组，且干预组排气时间、排便时间、下床活动时间、恢复正常饮食时间、伤口愈合时间、住院时间均短于参照组，P < 0.05。结论：FTS护理能有效降低腹腔镜胆囊切除术高龄患者生理和心理应激反应，缩短术后机体恢复时间，减少并发症风险，值得临床应用。

Abstract: Objective: To explore the effect of rapid rehabilitation surgical nursing on stress response and re-covery of elderly patients undergoing laparoscopic cholecystectomy. Methods: Ninety elderly pa-tients who underwent laparoscopic cholecystectomy in our hospital from June 2016 to August 2018 were selected as study samples. They were divided into control group and intervention group by random sequence software odd and even number method. The reference group received routine perioperative nursing, while the intervention group received FTS nursing on the basis of the above. The surgical stress response, postoperative recovery and complication rate were compared between the two groups. Results: The 24h Cor, FPG, IL-6, CRP, adrenaline levels, SAS, SDS scores and complications in the intervention group were lower than those in the control group, and the exhaust time, defecation time, time to get out of bed, time to resume normal diet, wound healing time and hospitalization time in the intervention group were shorter than those in the control group, P < 0.05. Conclusion: FTS nursing can effectively reduce the physiological and psychological stress response of elderly patients after laparoscopic cholecystectomy, shorten the recovery time and reduce the risk of complications, which is worthy of clinical application.