损伤控制理念在腹腔镜全胃切除术的围术期护理应用研究

目的探讨应用损伤控制理念指导的腹腔镜辅助下全胃切除术的围术期护理。方法回顾性总结分析在损伤控制理念指导下61例腹腔镜辅助下全胃切除术患者的围术期护理经验。不常规留置胃管,术中注意保温,控制输液速度和输液量,术后早期肠内营养支持,注意鼻肠管护理及饮食护理。结果全部手术均获成功,平均排气时间69 h（51~82）h,平均住院时间11 d（9~14）d,无死亡及吻合口瘘。结论将损伤控制理念运用于腹腔镜全胃切除术的围术期护理实践,改进了传统的护理方法,提高了患者的手术耐受度,降低感染,并发症少,患者恢复快,住院时间短。

Applied research on the damage control in perioperative nursing of laparoscopic total gastrectomy

Objective To explore the application of damage control in perioperative nursing of laparoscopic whole gastrectomy.Methods The perioperative nursing experience of 61 patients who received laparoscope-assisted whole gastrectomy in accordance with the philosophy of damage control was retrospectively analyzed.Indwelling gastric tube was not performed routinely, body temperature was maintained,transfusion speed and quantity were controlled,early external nutrition support was provided,nasal-intestinal tube nursing and diet nursing were conducted.Results Operations succeeded in all patients,the median flatulence time was 69 h（51-82） h,and median hospitalization duration was 11 d（9-14） d,and no death or anastomotic leakage was recorded.Conclusion The application of damage control in perioperative nursing of laparoscopic whole gastrectomy can improve the traditional nursing method with higher tolerance,lower infection or complications,faster recovery and shorter hospitalization.