加速康复护理在腹腔镜子宫全切术患者中的应用研究

  目的  探讨加速康复护理在腹腔镜子宫全切术患者中的应用效果，为提高护理质量提供依据。  方法  选取2020年7—12月温州医科大学附属第一医院收治的220例行腹腔镜子宫全切手术的患者，按照随机数字表法分为对照组和观察组，每组110例。对照组给予常规护理干预，观察组则给予加速康复护理，包括术前减轻患者的焦虑、抑郁情绪，缩短禁食禁水时间；术中限制性输液；术后早期进食、早期拔管、早期运动锻炼、疼痛管理等护理措施。比较2组患者心理状态、疼痛评分、术后恢复情况、并发症发生率。  结果  护理后(术前1 d), 观察组SAS和SDS评分显著低于对照组(均P＜0.05)。观察组术后不同时间的NRS评分均显著低于对照组，差异有统计学意义(均P＜0.05)。观察组首次排气时间、首次下床活动时间、术后住院时间分别为(16.73±1.65)h、(12.78±1.43)h和(3.71±0.42)d，均显著低于对照组(20.61±2.38)h、(21.06±2.45)h和(5.03±0.65)d], 差异有统计学意义(均P＜0.05)。观察组并发症发生率为5.45%，显著低于对照组的29.09%(P＜0.05)。  结论  加速康复护理应用于腹腔镜子宫全切术患者临床效果理想，值得推广。 

Application effect of fast rehabilitation nursing on patients after laparoscopic hysterectomy

  Objective  To study the application effect of fast rehabilitation nursing on patients after laparoscopic hysterectomy and to provide a basis for improving the quality of nursing.  Methods  A total of 220 patients who underwent laparoscopic hysterectomy from July to December 2020 were randomly divided into the control group and observation group, with 110 cases in each group. The control group was given routine nursing intervention, whilst the observation group was given fast rehabilitation nursing, including reducing the anxiety and depression of patients, shortening the time of fasting and water deprivation before operation, limited intraoperative infusion, early postoperative feeding, early extubation, early exercise, pain management and other nursing measures. The psychological status, pain score, postoperative recovery and complication rate of both groups were compared.  Results  After nursing (one day before the operation), the SAS and SDS scores of the observation group were significantly lower than those of the control group (all P < 0.05). The NRS scores of the observation group at different time points after operation were significantly lower than those of the control group (all P < 0.05). The first exhaust time, the first ambulation time and the postoperative hospital stay of the observation group were (16.73±1.65) h, (12.78±1.43) h and (3.71±0.42) days, which were significantly lower than those of the control group (20.61±2.38) h, (21.06±2.45) h and (5.03±0.65) days], respectively (all P < 0.05). The incidence of complications in the observation group was 5.45%, which was significantly lower than that (29.09%) in the control group (P < 0.05).  Conclusion  The clinical effect of fast rehabilitation nursing in patients after laparoscopic hysterectomy is good, which is worthy of clinical promotion.