唐彩萍等

[摘要] 目的 探讨快速康复外科（fast track surgery，FTS）护理在行消化道手术的患者术后恢复中的应用。 方法 将74例消化道手术患者分为快速康复组和传统护理组，每组37例。快速康复组围手术期接受快速康复外科护理，传统护理组接受传统的围手术期护理。观察术后首次排气、排便时间、营养状况、术后住院时间、住院总费用及术后并发症等。 结果 两组患者均痊愈出院，无一例死亡。与传统手术相比，快速康复组术后患者住院总时间明显缩短、住院总费用明显减少、首次排气及排便时间提前、营养状况较好、总体并发症发生率明显降低，且对医护质量满意度较好（P<0.05）。 结论 快速康复外科护理模式在消化道手术患者术后恢复中安全可行，加快了患者术后康复，缩短了术后住院时间，减少并发症，降低了医疗费用，值得推广。

[关键词] 快速康复；外科护理；消化道术后；恢复

[中图分类号] R730.76 [文献标识码] B [文章编号] 1673-9701（2015）09-0154-03

Application of fast track surgery nursing in recovery of gastrointestinal postoperative patients

TANG Caiping1 LI Yimin2

1.Department of Surgery，Branch of Zhejiang Hospital，Hangzhou 310030，China；2.No.1 People's Hospital of Hangzhou， Zhejiang Province， Hangzhou 310030，China

[Abstract] Objective To explore application of fast track surgery nursing of gastrointestinal postoperative patients recovery. Methods All 74 patients undergoing gastrointestinal operation were divided into FTS nursing group（37 cases） and traditional nursing group（37 cases）. The patients in FTS nursing group received fast track surgery perioperative nursing and the patients in traditional nursing group received traditional perioperative nursing. The time to first exhaust， first defecation， hospitalization after operation，nutritional status，the total cost of hospitalization，postoperative complications， and the satisfaction were observed. Results The patients of two groups recovered and discharged， and no cases died. The time to first exhaust， first defecation， and hospitalization after operation in FTS nursing group were significantly shorter than those in traditional nursing group. The total cost of hospitalization in FTS nursing group were significantly decreased than those in traditional nursing group. The nutritional status in FTS nursing group were better than those in traditional nursing group. The general postoperative complications in FTS nursing group were decreased than those in traditional nursing group. The satisfaction in FTS nursing group was better than that in traditional nursing group. There were statistically significant differences（P<0.05）. Conclusion FTS nursing model was safe and feasible in recovery of gastrointestinal postoperative patients，and could accelerate postoperative recovery，shorten the time to hospitalization after operation，reduce postoperative complications and medical cost，so it was worth popularizing.

[Key words] Fast track rehabilitation；Nursing of surgery；Gastrointestinal postoperative；Recovery

消化道手术由于手术创伤及术后营养等方面的影响，术后患者往往在机体功能等方面恢复较差，包括疼痛、消化功能紊乱及营养障碍等多方面问题[1，2]。在围手术期采取确实有效的措施加速其康复，能明显改善患者的营养状况、减轻疼痛、促进胃肠功能的恢复，避免相关并发症的发生、缩短住院时间，降低住院总费用，保障医疗安全，提高患者的满意度。加速康复外科（fast track surgery，FTS）护理符合上述理念，其要求以患者为中心，采用一系列经循证医学证实有效的围术期优化措施以减少手术应激损害，维持患者内环境稳定，减轻患者心理和生理的应激反应，加快术后康复[3，4]。本研究以快速康复外科理念应用于消化道手术患者的围手术期中，并以同期行传统护理为对照，以证实其安全性和有效性。……