张新

【摘要】 目的 探討高龄急性化脓性胆囊炎手术治疗的临床护理方法及效果， 为临床治疗提供参考。方法 60例高龄急性化脓性胆囊炎患者， 随机分为观察组和对照组， 各30例。对照组患者采用常规护理方法， 观察组患者采用综合护理方法。对比两组患者手术前1 d和麻醉前的心率、收缩压；两组患者手术后并发症发生率、护理满意度、手术后引流时间、住院时间。结果 两组患者手术前1 d的心率、收缩压比较， 差异无统计学意义（P>0.05）；观察组麻醉前的心率、收缩压均优于对照组， 差异具有统计学意义 （P<0.05）。观察组患者的术后并发症发生率为3.33%、护理满意度为96.67%， 均优于对照组的20.00%、76.67%， 差异均具有统计学意义 （P<0.05）。观察组患者的术后术后引流时间为（2.2±0.5）d、住院时间为（10.1±2.2）d， 均短于对照组的（3.8±1.2）、（15.4±3.4）d， 差异均具有统计学意义 （P<0.05）。结论 因为高龄急性化脓性胆囊炎患者的抵抗力和耐受力比较差， 加之手术过程较为复杂， 所以对其采用综合护理的方法有助于其心率水平、收缩压的改善， 有助于预后， 值得临床应用与推广。

【关键词】 高龄急性化脓性胆囊炎；手术；临床护理

DOI：10.14163/j.cnki.11-5547/r.2017.02.075

Clinical nursing of surgical treatment of senile acute suppurative cholecystitis and its effect observation ZHANG Xin. Department of General Surgery， Liaoning Province Jinzhou City Central Hospital， Jinzhou 121000， China

【Abstract】 Objective To explore clinical nursing of surgical treatment of senile acute suppurative cholecystitis and its effect to provide reference for clinical treatment. Methods A total of 60 senile acute suppurative cholecystitis were randomly divided into observation group and control group， with 30 cases in each group. The control group received conventional nursing Methods， and the observation group received comprehensive nursing method. Comparison were made on heart rate and systolic pressure in 1 d before operation and before anesthesia， incidence of postoperative complications， nursing satisfactory degree， postoperative drainage time and hospital stay time in two groups. Results There was no statistically significant difference in hear rate and systolic pressure in 1 d before operation between two groups （P>0.05）. The observation group had better heart rate and systolic pressure before anesthesia than the control group， and the difference had statistical significance （P<0.05）. The observation group had incidence of postoperative complications as 3.33%， nursing satisfactory degree as 96.67%， which were all better than 20.00% and 76.67% in the control group， and their differences had statistical significance （P<0.05）. The observation group had postoperative drainage time as （2.2±0.5）d， hospital stay time as （10.1±2.2） d， which were all shorter than （3.8±1.2） and （15.4±3.4） d in the control group， and their differences had statistical significance （P<0.05）. Conclusion Due to poor resistance and tolerance in senile patients with acute suppurative cholecystitis， along with complicated surgery procedures， comprehensive nursing method is beneficial for improvement of heart rate level and systolic pressure， and it is helpful for prognosis. So this method is worthy of clinical application and promotion.

【Key words】 Senile acute suppurative cholecystitis； Surgery； Clinical nursing

急性化脓性胆囊炎是临床常见的急腹症， 如果处理不及时或者处理不当， 会造成严重后果， 甚至威胁患者的生命安全， 近年来随着我国人口老龄化程度的加深， 使其呈上升趋势， 临床对其治疗是以手术治疗为主， 其中手术方式、时机、术后处理、围术期护理是影响治疗效果和并发症的关键因素[1-4]。本研究选取本院2015年1月～2016年1月收治的高龄急性化脓性胆囊炎患者60例为研究对象进行分组研究， 探讨高龄急性化脓性胆囊炎手术治疗的临床护理， 并观察其效果。

1 资料与方法

1. 1 一般资料 选取本院2015年1月～2016年1月收治的高龄急性化脓性胆囊炎患者60例为研究对象， 患者均接受手术治疗， 并愿意签订知情同意书。通过观察患者的临床表现， 了解患者的病史， 并进行B超、CT等检查， 所有患者都符合高龄急性化脓性胆囊炎的诊断标准， 随机分为观察组和对照组， 各30例。观……