快速康复外科对腹腔镜胆囊切除术围术期康复效果及预后的影响

doi:10.3969/j.issn.1671-7171.2019.12.008

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摘要 【目的】研究快速康复外科(Fast track surgery,FTS)对胆囊炎/胆囊结石腹腔镜胆囊切除术围术期康复效果及预后的影响。【方法】选取南京市中心医院2017年4月至2019年4月收治的80例拟行腹腔镜胆囊切除术的胆囊炎或胆囊结石患者,随机分为观察组及对照组,各40例。对照组接受常规围术期干预,观察组接受FTS理念指导下的围术期干预。比较两组手术及恢复情况、并发症发生率以及术前、术后1周生活质量评分变化,分析FTS对患者康复效果及预后的影响。【结果】观察组手术时间、术中出血量、术后进食时间、下床活动时间、排气时间、麻醉苏醒后VAS评分及住院时间均低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为5 %,低于对照组的20 %,差异有统计学意义(P<0.05)。两组术后7 d生理机能、身体疼痛、一般健康状况、精力、社会功能及精神健康评分均较术前改善,观察组术后7 d生理机能、身体疼痛、一般健康状况、精力、精神健康评分高于对照组同期水平,差异有统计学意义(P<0.05)。【结论】FTS能够提高腹腔镜胆囊切除术康复效果,改善其术后生活质量。

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	张艳艳
	马燕

关键词 ：胆囊切除术, 腹腔镜/护理, 康复护理

Abstract：【Objective】To study the effect of rapid rehabilitation surgery called Fast track surgery (FTS) on perioperative rehabilitation and prognosis of cholecystitis/gallstone laparoscopic cholecystectomy. 【Methods】A total of 80 patients with cholecystitis or gallstones undergoing laparoscopic cholecystectomy in Nanjing central hospital from April 2017 to April 2019 were randomly divided into the observation group and the control group, with 40 cases in each group. The control group received routine perioperative intervention, while the observation group received perioperative intervention under the guidance of FTS concept. The status of operation and recovery, the incidence of complications and the changes of quality of life score before surgery and 1 week after operation in the two groups were compared. Effects of FTS on the rehabilitation and prognosis of patients was analyzed. 【Results】The operation time, intraoperative blood loss, postoperative feeding time, time to get out of bed, exhaust time, VAS score and hospitalization time of the observation group were lower than those of the control group. The differences were statistically significant (P<0.05). The incidence of postoperative complications in the observation group was 5.00%,which was lower than 20.00% in the control group (P<0.05). The scores of physiological function, physical pain, general health status, energy, social function and mental health of the two groups were improved 7 days after operation. The scores of physical function, physical pain, general health status, energy and mental health of the observation group were higher than those of the control group at the same time. The differences were statistically significant (P<0.05). 【Conclusion】Fast-track surgery can improve the rehabilitation effect of laparoscopic cholecystectomy and the quality of life after surgery.

Key words： Cholecystectomy Laparoscopic/NU Rehabilitation Nursing

收稿日期: 2019-10-10

PACS:

R575.6

基金资助:2019年江苏省医药卫生科技计划项目(编号2019YG649)

引用本文:

张艳艳, 马燕. 快速康复外科对腹腔镜胆囊切除术围术期康复效果及预后的影响[J]. 医学临床研究, 2019, 36(12): 2310-2312.
ZHANG Yan-yan, MA Yan. Effect of Fast-track Surgery on Perioperative Rehabilitation and Prognosis of Laparoscopic Cholecystectomy. JOURNAL OF CLINICAL RESEARCH, 2019, 36(12): 2310-2312.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.12.008 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I12/2310

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