范月秀+廖秋梅+范会琴+胡鲜艳

[摘要]目的 探討临床护理路径在腹股沟疝腹腔镜完全腹膜外疝修补术（TEP）患者中的效果。方法 选取2015年6月～2016年12月我院收治的腹股沟疝患者82例，随机分为观察组与对照组，各41例。所有患者采取TEP治疗，对照组采取常规护理，观察组采取临床护理路径干预。比较两组患者术后排气时间、下床活动时间、术后住院时间、术后恢复时间、并发症、护理满意度及血清中CRP水平。结果 观察组的术后排气时间、下床活动时间、术后住院时间以及术后恢复时间均短于对照组，并发症发生率低于对照组，护理满意度高于对照组，差异有统计学意义（P<0.05）。术前，两组患者血清中CRP水平比较，差异均无统计学意义（P>0.05）；术后12、24 h两组患者的血清中CRP水平有所提高，与术前比较，差异有统计学意义（P<0.01）；但观察组水平低于对照组，差异有统计学意义（P<0.01）。结论 临床护理路径可缩短腹股沟疝TEP患者术后排气时间、术后下床时间、术后住院时间以及术后恢复时间，减少并发症，提高患者的满意度，降低血清CRP水平。

[关键词]临床护理路径；腹腔镜；完全腹膜外疝修补术；腹股沟疝

[中图分类号] R473.6 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0179-04

Efficacy of clinical nursing pathway on inguinal hernia patients with laparoscopic total peritoneal hernia repair

FAN Yue-xiu LIAO Qiu-mei FAN Hui-qin HU Xian-yan

Department of Gastroenterology，Fogang County People′s Hospital in Guangdong Province，Fogang 511600，China

[Abstract]Objective To investigate efficacy of clinical nursing pathway on inguinal hernia patients with laparoscopic total peritoneal hernia repair（TEP），and the influence on serum level of C-reactive protein （CRP）.Methods 82 patients with inguinal hernia in our hospital from June 2015 to December 2016 were selected and randomly divided into the control group and the observation group，with 41 cases in each group，all cases were treated with TEP.The control group was given with routine nursing care，while the observation group was given clinical nursing pathway.The postoperative exhaust time，off-bed activity time，length of hospital stays，postoperative recovery time，complication，nursing satisfaction and serum CRP were compared between two groups.Results The postoperative exhaust time，off-bed activity time，length of hospital stays and postoperative recovery time in the observation group were shorter than those in the control group，the incidence of complication was lower than that in the control group，and the differences were statistically significant （P<0.05）.Before operation，there were no significant differences in the level of serum CRP between two groups （P>0.05）；12，24 h after operation，the level of serum CRP in two groups were all increased，and compared with those before operation，the differences were statistically significant （P<0.01），but those in the observation group was lower than those in the control group，and the differences were statistically significant （P<0.01）.Conclusion Clinical nursing pathway can shorten time of postoperative exhaust time，bed time after operation，postoperative hospitalization，postoperative recovery time for inguinal hernia patients after TEP，reduce complications，increase satisfaction，and inhibiting serum level of CRP.endprint

[Key words]Clinical nursing pathway；Laparoscopic；Total peritoneal hernia repair；Inguinal hernia

临床护理路径是针对特定患群的一种住院护理模式，以时间为横轴，以入院指导、接诊时诊断、检查、用药、护理、治疗、活动、饮食指导、教育以及出院指导等为纵轴，根据需要给予相应干预措施，为患者提供一套系统、标准、连续且针对性强的护理措施，增强患者自我护理意识和能力，利于患者康复[1-2]。腹股沟疝是普外科常见疾病之一，调查显示其发病率约为3.6%[3]。Meta分析显示，在腹股沟疝修补术临床护理中，临床护理路径获得的效果明显优于常规护理[4]。本组研究选取接受腹股沟疝完全腹膜外疝修补术（TEP）的患者，应用临床护理路径护理和常规护理进行随机对照试验研究，取得了满意的效果，现报道如下。……