黄妙玲 莫燕霞 钟淑冰

【摘要】 目的：探讨基于FTS理念的日间手术病房管理在老年腹腔镜胆囊切除手术患者中的应用效果。方法：选择2015年10月-2019年2月笔者所在医院收治的老年腹腔镜胆囊切除手术患者96例，采用随机数字表法分为两组，各48例。对照组接受常规围术期护理，试验组实施基于FTS理念的日间手术病房管理。对比两组术后疼痛、并发症发生率及恢复效果。结果：试验组术后6、12、36 h VAS评分均低于对照组，差异均有统计学意义（P<0.05）;试验组术后并发症总发率低于对照组，差异有统计学意义（P<0.05）;试验组术后下床活动时间、排气时间早于对照组，住院时间短于对照组，差异均有统计学意义（P<0.05）。结论：基于FTS理念的日间手术病房管理在老年腹腔镜胆囊切除手术患者中应用效果显著，可减轻患者术后疼痛，降低术后并发症发生率，促进患者康复。

【关键词】 腹腔镜胆囊切除术 FTS理念 术后疼痛 并发症 恢复效果

doi：10.14033/j.cnki.cfmr.2020.20.049 文獻标识码 B 文章编号 1674-6805（2020）20-0-03

Application Effect of Daytime Surgical Ward Management Based on FTS Concept in Elderly Patients Undergoing Laparoscopic Cholecystectomy/HUANG Miaoling， MO Yanxia， ZHONG Shubing. //Chinese and Foreign Medical Research， 2020， 18（20）： -123

[Abstract] Objective： To explore the effect of daytime surgical ward management based on FTS concept in elderly patients undergoing laparoscopic cholecystectomy. Method： A total of 96 elderly patients undergoing laparoscopic cholecystectomy in our hospital from October 2015 to February 2019 were randomly divided into two groups （n=48）. The control group received routine perioperative nursing， and the experimental group received daytime surgical ward management based on FTS concept. The postoperative pain， the incidence of complications and the recovery effect were compared between the two groups. Result： The VAS scores at 6， 12 and 36 h after surgery in the experimental group were all lower than those in the control group， the differences were statistically significant （P<0.05）. The total incidence rate of postoperative complications in the experimental group was significantly lower than that in the control group， the difference was statistically significant （P<0.05）. The time of getting out of bed， the time of exhaust in the experimental group were earlier than those in the control group， and the time of hospitalization in the experimental group was significantly shorter than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： The management of daytime operation ward based on FTS concept is effective in elderly patients undergoing laparoscopic cholecystectomy. It can reduce the postoperative pain， reduce the incidence of postoperative complications and promote the rehabilitation of elderly patients undergoing laparoscopic cholecystectomy.

[Key words] Laparoscopic cholecystectomy FTS concept Postoperative pain Complications Recovery effect

First-authors address： Dongguan Peoples Hospital， Dongguan 523000， China

腹腔镜胆囊切除手术是肝胆外科常用术式，较传统开放手术安全性更高，且适用于各种胆囊良性病变[1-2]。但老年患者各生理机能、系统功能逐步退化，各脏腑器官代偿功能减退，对各类应激的耐受能力也随之降低，围术期安全风险较高，如何确保老年患者围术期安全是护理干预重点[3]。加速康复外科理念（FTS）是将微创外科与麻醉学、护理学等多学科综合起来的手术护理模式，主要在围术期实施一系列具有目的性的护理措施，以降低术后并发症发生风险，促进患者术后恢复[4-5]。为此，本研究在老年腹腔镜胆囊切除手术患者中实施基于FTS理念的日间手术病房管理，旨在探讨其对患者恢复效果的影响，现将结果示下。

1 资料与方法

1.1 一般资料

选择2015年10月-2019年2月笔者所在医院收治的老年腹腔镜胆囊切除手术患者96例。纳入标准：（1）年龄≥60岁;（2）具有腹腔镜手术适应证。……