徐伟 杨迎春 陈艳蓉 李晶晶 张妍妮

摘要：目的  探討快速康复外科 （FTS）理念在经后颅窝乙状窦后入路三叉神经微血管减压术围术期患者护理中的应用效果。方法  选择2018年1月～2019年1月我院收治并行经后颅窝乙状窦后入路三叉神经微血管减压患者100例，随机分成观察组和对照组，每组50例。对照组应用常规方法进行围术期护理，观察组应用FTS理念进行围术期护理。比较两组焦虑情况、术后并发症发生率、平均住院日及平均住院费用。结果  观察组轻度焦虑多于对照组，中、重度焦虑少于对照组（P<0.05）;观察组术后并发症发生率低于对照组[恶心呕吐（4.00% vs 16.00%）、尿路感染（4.00% vs 18.00%）、颅内感染（0 vs 8.00%）、颅内血肿（2.00% vs 14.00%）和术后应激性疼痛（16.00% vs 34.00%）]，差异有统计学意义（P<0.05）;观察组平均住院日和平均住院费用均低于对照组[（9.13±1.14）d vs（12.44±0.89）d];[（2.15±0.66）万元 vs （3.05±0.61）万元]，差异有统计学意义（P<0.05）。结论  应用FTS理念能缓解经后颅窝乙状窦后入路三叉神经微血管减压术患者术前紧张恐惧的心理，减少术后并发症，缩短患者住院日，降低住院费用，护理效果较好。

关键词：快速康复外科;乙状窦后入路三叉神经微血管减压术;外科护理

中图分类号：R745.1+1                             文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2020.01.061

文章编号：1006-1959（2020）01-0182-03

Fast Track Surgery Nursing of Trigeminal Nerve Microvascular Decompression Via Posterior Cranial Fossa Posterior Sigmoid Sinus Approach

XU Wei，YANG Ying-chun，CHEN Yan-rong，LI Jing-jing，ZHANG Yan-ni

（Four Wards of Neurosurgery，the Second Hospital of Lanzhou University，Lanzhou 730030，Gansu，China）

Abstract：Objective  To explore the effect of the concept of fast track surgery（FTS） in the nursing of patients with trigeminal nerve microvascular decompression in the posterior cranial fossa approach. Methods  From January 2018 to January 2019， 100 patients with trigeminal nerve microvascular decompression who underwent posterior cranial fossa retrosigmoid sinus approach were randomly divided into observation group and control group， with 50 cases in each group. The control group applied routine methods for perioperative nursing， and the observation group applied FTS concept for perioperative nursing. The SAS scores， the incidence of postoperative complications， the average hospitalization days， and the average hospitalization costs were compared between the two groups. Results  A low level of anxiety in observation group was more than that in control group， a moderate and high level of anxiety in observation group was less than control group（P<0.05）; the incidence of postoperative complications in the observation group was lower than that of the control group [nausea and vomiting （4.00% vs 16.00%）， urinary tract infection （ 4.00% vs 18.00%）， intracranial infection （0 vs 8.00%）， intracranial hematoma （2.00% vs 14.00%）， and postoperative stress pain （16.00% vs 34.00%）， the differences were statistically significant （P<0.05）; the average hospitalization day and average hospitalization cost of the observation group were lower than those of the control group [（9.13±1.14） d vs （12.44±0.89）] d;[（2.15±0.66） ten thousand yuan vs （3.05±0.61） ten thousand yuan]，the difference was statistically significant （P<0.05）. Conclusion  The application of the FTS concept can alleviate the tension and fear of patients with trigeminal nerve microvascular decompression after the posterior cranial fossa sinus approach， reduce postoperative complications， shorten the length of hospital stay， reduce the cost of hospitalization， and provide good nursing results.

Key words：Fast track surgery;Trigeminal nerve microvascular decompression with retrosigmoid approach;Surgical nursing

快速康复外科（fast track surgery，FTS）是一种在围术期通过各种方法降低患者手术应激反应及相关并发症，帮助患者术后更快康复的医学新理 念[1，2]。FTS的实现主要靠麻醉、微创手术操作及围术期护理3个环节[3]，其中，围术期护理操作对FTS的实现尤为重要。三叉神经痛是一种常见的脑神经疾病，随着微创技术在神经外科的广泛应用，经后颅窝乙状窦后入路三叉神经微血管减压术成为治疗原发性三叉神经痛的首选外科微创手术方法[4]。为了促进患者快速康复，本研究对我科应用FTS的理念进行经后颅窝乙状窦后入路三叉神经微血管减压术围术期护理的100例患者护理效果进行分析，现报道如下。

1资料与方法

1.1一般资料  选取2018年1月～2019年1月兰州大学第二医院神经外科收治的确诊为原发性三叉神经痛，行经后颅窝乙状窦后入路三叉神经微血管减压术的患者100例。……