王丽霞

[摘要]目的 探讨快速康复外科理念在腹腔镜胆囊切除术患者中的应用。方法 选取2018年3月～2019年3月我院收治的116例行腹腔镜胆囊切除术患者作为研究对象，按照红蓝双色球法分为对照组（58例）与观察组（58例），对照组采用常规护理，观察组采用快速康复外科理念实施护理，比较两组的术后恢复情况及并发症发生情况。结果 观察组的输液总量为（9.09±3.17）L，少于对照组的（13.24±4.15）L，差异有统计学意义（P<0.05）。观察组的术后疼痛评分为（3.12±0.53）分，低于对照组的（5.29±0.47）分，差异有统计学意义（P<0.05）;观察组的排气时间为（26.27±6.49）h，下床活動时间为（1.14±0.38）d，住院时间为（5.79±0.93）d，均短于对照组的（40.08±4.28）h、（2.82±0.64）d、（7.82±0.97）d，差异有统计学意义（P<0.05）。观察组患者的胆漏、肺部感染、切口感染、腹腔积液并发症总发生率（8.62%）低于对照组（24.14%），差异有统计学意义（P<0.05）。结论 应用快速康复外科理念有助于缓解腹腔镜胆囊切除术患者的疼痛感，减少胆漏、肺部感染、切口感染、腹腔积液等并发症的发生，缩短患者的排气时间、下床活动时间，促进其早日康复，顺利康复出院。

[关键词]腹腔镜胆囊切除术;快速康复外科;并发症;疼痛

[中图分类号] R657.4          [文献标识码] A          [文章编号] 1674-4721（2020）8（b）-0085-04

[Abstract] Objective To explore the application of the concept of rapid rehabilitation surgery in patients with laparoscopic cholecystectomy. Methods A total of 116 patients who laparoscopic cholecystectomy in our hospital from March 2018 to March 2019 were selected as the research objects. They were divided into a control group （58 cases） and an observation group （58 cases） according to the red and blue color ball method. The control group adopted routine nursing， and the observation group adopted rapid rehabilitation surgery. The postoperative recovery and complications of the two groups were compared. Results The total amount of infusion in the observation group was （9.09±3.17） L， which was less than that in the control group of （13.24±4.15） L， the difference was statistically significant （P<0.05）. The postoperative pain score of the observation group was （3.12±0.53） points， which was lower than that of the control group of （5.29±0.47） points， the difference was statistically significant （P<0.05）. The exhaust time of the observation group was （26.27±6.49） h， the time to get out of bed was （1.14±0.38） d， the hospitalization time was （5.79±0.93） d， which were shorter than those in the control group of （40.08±4.28） h， （2.82±0.64） d， （7.82±0.97） d， and the differences were statistically significant （P<0.05）. The total incidence of complications such as bile leakage， lung infection， incision infection， and peritoneal effusion in the observation group （8.62%） was lower than that in the control group （24.14%）， the difference was statistically significant （P<0.05）. Conclusion Applying the concept of rapid rehabilitation surgery can help alleviate pain in patients with laparoscopic cholecystectomy， reduce occurrence of complications such as bile leakage， lung infections， incision infections， and peritoneal effusions， shorten the patients′ exhaust time， get out of bed time， and promote their early recovery and smooth discharge from hospital.

[Key words] Laparoscopic cholecystectomy; Rapid rehabilitation surgery; Complications; Pain

随着医学技术的进步和发展，腹腔镜手术在胆道疾病的治疗中得到了广泛应用，但患者受手术创伤、应激因素的影响，在术后常伴有不同程度的疼痛感，易产生恐惧、紧张心理，加剧应激反应，进而增加并发症的发生风险[1-3]。实践证明，在腹腔镜胆囊切除术围术期展开护理干预，对患者术后尽快恢复发挥着积极的作用[4-6]。由丹麦外科医生Kehlet提出的快速康复外科理念，要求医护人员通过制定一系列的围术期护理措施，减轻患者手术应激反应，减少并发症，从而促进患者术后尽早恢复[7-9]。为探讨科学合理的护理模式，本研究就快速康复外科理念在腹腔镜胆囊切除术患者中的应用效果进行了探索，现报道如下。

1资料与方法

1.1一般资料

选取2018年3月～2019年3月我院收治的116例行腹腔镜胆囊切除术患者作为研究对象，按照红蓝双色球法分为观察组（58例）与对照组（58例）。观察组中，男33例，女25例;年龄32～71岁，平均（43.29±4.28）岁;包括胆结石37例，胆囊息肉21例。……