宋依妹 周奂奂 黄玉彬

[摘要]目的 探讨预康复在腹腔镜胆囊切除术（LC）患者的应用效果。方法 选取2018年4月～2019年1月我院收治的78例LC患者作为研究对象，根据入院时间分为观察组和对照组，每组各39例。对照组进行常规术前护理，观察组在对照组基础上行预康复方案。对两组焦虑与疼痛评分、住院时间、肛门排气时间、术后并发症发生率进行评定。结果 实施预康复后，观察组的焦虑与疼痛评分、术后并发症总发生率低于对照组，观察组住院时间、肛门排气时间短于对照组，差异均有统计学意义（P<0.05）。结论 预康复模式的应用可有效促进LC患者术后康复。

[关键词]预康复;腹腔镜胆囊切除术;功能训练;焦虑;疼痛

[中图分类号] R473.6          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0244-04

Application effect of pre-habilitation intervention in laparoscopic cholecystectomy

SONG Yi-mei   ZHOU Huan-huan   HUANG Yu-bin

Department of Hepatobiliary Surgery， District 14， Fujian Provincal Hospital， Fuzhou   350001， China

[Abstract] Objective To explore the application effect of pre-habilitation intervention for patients after laparoscopic cholecystectomy （LC）. Methods A total of 78 LC patients who were admitted to our hospital from April 2018 to January 2019 were selected as the study objects. According to the time of admission， they were divided into the observation group and the control group， 39 cases in each group. The control group was given routine care during perioperative period， and the observation group was given pre-habilitation intervention. The anxiety and pain scores， hospital stay， time of anal exhaust， and the total incidence of postoperative complications between two groups were compared. Results After pre-habilitation intervention， the scores of anxiety and pain and the total incidence of postoperative complications in the observation group were lower than those in the control group， while the hospitalization time and anal exhaust time in the observation group were shorter than those in the control group， the differences were statistically significant （P<0.05）. Conclusion The application of pre-rehabilitation model can accelerate the recovery after LC.

[Key words] Pre-habilitation; Laparoscopic cholecystectomy; Functional training; Anxiety; Pain

腹腔镜胆囊切除术（laparoscopic cholecystectomy， LC）作为一种微创手术，在不缩小手術野的情况下，有通道创伤小、疼痛小、恢复早等优点，已成为治疗胆囊结石疾病的典型手术方式[1]。但由于手术引起的心理应激反应、术后切口疼痛、卧床、留置引流管不同程度影响患者术后恢复[2]。因此如何在术前阶段对患者评估、管理和优化，减少并发症并加速术后康复，成为快速康复（ERAS）研究的热点。近年来，随着ERAS在临床推广，预康复也越来受到重视，预康复是基于ERAS优化理念提出的术前管理新策略，早期着重强调术前优化患者运动功能能力，增强个体功能储备，使患者更好承受手术应激，改善患者预后。预康复定义为“从疾病诊断到急性治疗（手术、放化疗）开始期间发生的一个连续性护理过程，包括运动训练、营养支持与教育、心理辅导”[3]。……