快速康复外科理念在胃肠道围术期护理中的应用效果

宋霞 李娜

[摘要] 目的 探討快速康复外科理念在胃肠道围术期护理中的效果。 方法 方便选取2016年2月—2018年9月在该院治疗的124例胃肠道手术患者，随机分组，对照组患者给予常规护理，实验组患者应用快速康复外科理念，观察比较两组患者临床指标、胃肠功能恢复时间、并发症发生率、负面情绪评分差异。结果 实验组住院时间（4.92±1.69）d、下床活动时间（18.27±3.57）h、首次排便时间（37.65±4.59）h、恢复普食时间（2.21±0.71）d较对照组明显下降（t=5.392、4.791、4.065、3.175，P=0.014、0.021、0.026、0.031）;实验组肠鸣音恢时间（18.39±4.07）h、肛门排气时间（3.41±0.95）h较对照组明显缩短（t=6.993、5.567，P=0.007、0.013）;实验组并发症发生率9.68%明显低于对照组（χ2=7.092，P=0.003）;实验组HAMD（11.09±2.45）分、HAMA（11.13±1.06）分同对照组比较明显下降（t=4.285、3.956，P=0.020、0.028）。结论 针对胃肠道围术期患者应用快速康复外科理念可改善临床指标，促进患者康复，降低并发症发生率，改善负面情绪，值得推广应用。

[关键词] 快速康复外科;胃肠道;围术期;护理

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0113-03

Application Effect of Rapid Rehabilitation Surgery Concept in Perioperative Nursing of Gastrointestinal Tract

SONG Xia， LI Na

Guihang Group 302 Hospital， Anshun， Guizhou Province， 561000 China

[Abstract] Objective To investigate the effect of rapid rehabilitation surgery on perioperative nursing of gastrointestinal tract. Methods Convenient selected a total of 124 patients with gastrointestinal surgery who were treated in the hospital from February 2016 to September 2018 were randomly divided into two groups. The patients in the control group were given routine nursing. The experimental group used the concept of rapid rehabilitation surgery to observe and compare the clinical indicators of the two groups， gastrointestinal function recovery time， complication rate， negative emotional scores. Results In the experimental group， the hospitalization time （4.92±1.69） d， the time of getting out of bed （18.27±3.57） h， the first defecation time （37.65±4.59） h， and the recovery time （2.21±0.71） d were significantly lower than the control group（t=5.392， 4.791， 4.065， 3.175， P=0.014， 0.021， 0.026， 0.031）; the experimental group bowel sound recovery time （18.39±4.07） h， anus exhaust time （3.41±0.95） h was significantly shorter than the control group（t=6.993， 5.567， P=0.007， 0.013）; the incidence of complications in the experimental group was 9.68%， which was significantly lower than that in the control group （χ2=7.092， P=0.003）. The experimental group was HAMD （11.09±2.45）points and HAMA （11.13±1.06）points， significantly decreased in the same control group （t=4.285， 3.956， P=0.020， 0.028）. Conclusion The application of rapid rehabilitation surgery in patients with gastrointestinal perioperative period can improve clinical indicators， promote patient recovery， reduce the incidence of complications， and improve negative emotions. It is worthy of popularization and application.

[Key words] Rapid rehabilitation surgery; Gastrointestinal tract; Perioperative period; Nursing

手术为高风险诊疗，创伤性刺激强，文献报道，手术过程中和术后患者应激指标明显改善，手术应激刺激带给患者不良影响，增加并发症发生率[1]。胃肠道疾病为临床常见疾病，患者易出现腹胀、消化不良等症状，因病程长，易引起胃肠功能障碍、营养不良，耐受性下降，麻醉刺激和手术刺激加重对胃肠道功能的损害，影响患者康复，胃肠道手术并发症风险高，发生腹腔感染，易导致器官功能障碍、脓毒血症等[2-3]。快速康复外科理念为新型护理模式，以患者康复为目的，但目前尚无统一标准，大部分患者缺乏对快速康……