加速康复外科护理对慢性鼻窦炎鼻内镜手术患者的干预效果

黄菊华

【摘要】 目的：探讨加速康复外科护理在慢性鼻窦炎鼻内镜手术中的临床干预效果。方法：选取本院2017年8月-2018年8月收治的慢性鼻窦炎患者40例进行研究，按照随机数字表法分为对照组和观察组，各20例。对照组仅进行常规的护理，观察组进行加速康复外科护理，比较两组手术前后口干程度和术后12、24、48、72 h疼痛程度，以及并发症发生率。结果：术前，两组口干程度比较，差异无统计学意义（P>0.05），观察组术后口干程度以及术后12、24、48、72 h疼痛程度均明显优于对照组，差异均有统计学意义（P<0.05）。观察组恶心呕吐、面部水肿、腰背疼痛、尿潴留发生率均明显低于对照组，差异均有统计学意义（P<0.05）。结论：加速外科康复护理明显减轻围手术期疼痛、口感等不适，降低并发症发生率，值得临床大力推广使用。

【关键词】 加速康复外科护理; 慢性鼻窦炎; 鼻内镜手术

【Abstract】 Objective：To discuss the clinical intervention effect of accelerated rehabilitation nursing on patients with chronic sinusitis and endoscopic surgery.Method：40 patients with chronic sinusitis admitted to our hospital from August 2017 to August 2018 were enrolled in the study.They were randomly divided into control group and observation group according to random number table method，20 cases in each group.The control group was only given routine nursing.The observation group was given accelerated rehabilitation surgery.The degree of dry mouth before and after surgery，the degree of pain at 12 h，24 h，48 h，72 h after surgery and the incidence of complications in two groups were compared.Result：There was no significant difference in the degree of dry mouth between the two groups before surgery（P>0.05）.The degree of postoperative dry mouth and the degree of pain at 12，24，48，72 h after surgery were significantly better than those in the control group，the differences were statistically significant（P<0.05）.The incidences of nausea and vomiting，facial edema，low back pain and urinary retention in the observation group were significantly lower than those of the control group，the differences were statistically significant（P<0.05）.Conclusion：Accelerated surgical rehabilitation nursing can significantly reduce perioperative pain，mouthfeel and other discomfort，and reduce the incidence of complications，which is worthy of clinical promotion.

【Key words】 Accelerated rehabilitation surgical nursing; Chronic sinusitis; Endoscopic surgery

First-authors address：Fuyong Peoples Hospital of Baoan District in Shenzhen City，Shenzhen 518103，China

doi：10.3969/j.issn.1674-4985.2019.16.024

近年來鼻窦炎患者明显增加，临床药物治疗的效果不佳，具有较高复发率，鼻内镜技术逐渐被用于慢性鼻窦炎的治疗，有效解决了患者的痛苦，具有创伤小、恢复快、手术彻底等优点[1-2]。然而鼻内镜手术易出现术后口干、面部水肿、伤口疼痛、腰背疼痛等围手术期不适[3-4]。由于微创理念、循证医学模式等的建立与改进，加速康复外科护理得到了成熟应用，为了进一步研究加速康复外科护理对慢性鼻窦炎鼻内镜手术的干预效果，特选取本院40例慢性鼻窦炎手术的患者进行研究，现报道如下。

1 资料与方法

1.1 一般资料 选取本院2017年8月-2018年8月收治的慢性鼻窦炎患者40例进行研究。纳入标准：参照《慢性鼻-鼻窦炎诊断和治疗指南（2012年，昆明）》确诊为慢性鼻窦炎者，患者均存在不同程度的鼻塞、黏性或黏脓性鼻涕、嗅觉减退、头面部肿痛症状，鼻内镜检查鼻炎膜充血、水肿，CT检查窦口鼻道复合体或黏膜存在炎性病变;无严重的肝肾功能异常;无恶性肿瘤疾病。排除……