综合路径在腹外疝修补术中的应用及对患者预后的影响

目的探究综合路径在腹外疝修补术中的应用价值及对患者预后的影响。 方法选取2017年1月至2018年10月，中国人民解放军联勤保障部队第904医院就诊的76例腹外疝患者，随机分为常规护理组（38例）和综合路径组（38例），所有患者均采用腹腔镜腹外疝修补术进行治疗，常规护理组患者给予围手术期常规护理，综合路径组患者则给予综合路径护理。观察并比较2组患者的术后恢复情况、切口恢复时间、疼痛时间、焦虑自评量表（self-rating anxiety scale，SAS）\抑郁自评量表（self-rating depression scale，SDS）评分以及术后并发症发生情况。 结果护理后，综合路径组患者肛门排气时间、下床活动时间、住院时间、切口恢复时间显著短于常规护理组，差异均有统计学意义（P<0.05）。护理后，2组患者的SAS和SDS评分均显著降低，且综合路径组的SAS和SDS评分显著小于常规护理组，差异均有统计学意义（P<0.05）。护理后，综合路径组的并发症发生率（2.63%）显著低于常规护理组（15.79%），差异有统计学意义（P<0.05）。 结论综合路径护理可显著缩短腹外疝修补术患者术后切口恢复时间，改善其负性情绪，减少术后并发症的产生，预后良好，值得临床推广与应用。

Effect on prognosis of patients underwent laparoscope repair of abdominal external hernia using application of comprehensive approach

ObjectiveTo explore the application of comprehensive approach in the laparoscopic repair of abdominal external hernia and its effect on the prognosis of patients. Methods76 patients with laparoscopic repair of abdominal external hernia who were treated in the surgery of the No. 904 hospital from January 2017 to October 2018 were randomly divided into the conventional nursing group (38 cases) and the comprehensive approach group (38 cases). All patients were treated with laparoscopic repair of abdominal external hernia. The conventional nursing group was given conventional perioperative nursing, while the comprehensive approach group was given comprehensive approach nursing. The recovery, time of incision recovery, time of pain, the score of self-rating anxiety scale (SAS), the score of self-rating depression scale (SDS) and complications were observed and compared between the two groups. ResultsAfter nursing, the time of anal exhaust, time of getting out of bed, time of hospitalization and time of incision recovery in the comprehensive approach group were significantly shorter than those in the conventional nursing group (P<0.05). After nursing, the scores of SAS and SDS in the two groups significantly decreased, and the scores of SAS and SDS in the comprehensive approach group were significantly lower than those in the conventional nursing group (P<0.05). After nursing, the incidence of complications in the comprehensive approach group (2.63%) was significantly lower than that in the conventional nursing group (15.79%) (P< 0.05). ConclusionComprehensive approach nursing can significantly shorten the recovery time after abdominal external hernia repair, improve the negative emotions, reduce the incidence of postoperative complications, and have a good prognosis. It is worthy of clinical promotion and application.