术前个体化护理访视在腹腔镜胆囊切除术中的应用效果

目的探讨术前个体化护理访视在腹腔镜胆囊切除术中的应用及效果。方法选择2012年3月～2013年5月湖州市中心医院收治行腹腔镜胆囊切除术的患者60例,随机分为研究组和对照组,每组各30例,研究组给予个体化术前访视及术前护理,对照组给予常规术前指导,于术前1 d（T1）、进入手术室后（T2）及麻醉前（T3）观察患者心率、血压,测定患者血皮质醇、肾上腺素、去甲肾上腺素浓度,并采用SAS评分评定患者焦虑程度。结果 T1时两组心率、血压、血浆皮质醇、肾上腺素及去甲肾上腺素浓度相比,差异无统计学意义（P〉0.05）,T2、T3时两组心率、血压、血浆皮质醇、肾上腺素、去甲肾上腺素、SAS评分均较T1时明显升高,差异有统计学意义（P〈0.05）,但上述指标研究组均明显低于对照组（P〈0.05）。结论术前个体化护理访视可有效减轻患者术前焦虑情绪及应激反应,利于患者手术管理及术后恢复,值得临床应用。

Application Effect of preoperative individualized care visits on patients with laparoscopic cholecystectomy

Objective To investigate the application effect of preoperative individualized care visits on laparoscopic cholecystectomy. Methods 60 patients who underwent laparoscopic cholecystectomy from March 2012 to May 2013 in Huzhou Central Hospital were randomly divided into study group and control group,with 30 patients in each group. Patients in study group were given individualized preoperative visit and preoperative care,patients in control group were given routine preoperative guidance,one day before surgery（T1）,in operating room（T2）,and before anesthesia（T2）,the heart rate,blood pressure of two groups were observed and recorded,venous blood were collected and cortisol,epinephrine,norepinephrine concentration were measured,and at each time point SAS scores were used to assess anxiety of patients. Results On T1 point,heart rate,blood pressure,plasma cortisol,epinephrine,and norepinephrine of two groups were not significantly different（P 0.05）; on T2,T3 point,the heart rate,blood pressure,plasma cortical,epinephrine,norepinephrine and SAS scores were increased compared with T1,but these indexes of the study group were significantly lower than those of the control group,the differences were statistically significant（P 〉0.05）. Conclusion Preoperative individualized care visits can effectively reduce preoperative anxiety and stress response,which will help the patient surgical management and postoperative recovery,is worthy of clinical application.