快速康复外科理念对行食管裂孔疝修补联合胃底折叠术患者的护理效果

目的探讨快速康复外科（fast track surgery，FTS）理念对行食管裂孔疝修补联合胃底折叠术患者的护理效果。 方法选取2017年2月至2018年5月，吉林大学第二医院收治的52例食管裂孔疝患者为研究对象，随机分为研究组与对照组，每组患者26例。2组均行食管裂孔疝修补联合胃底折叠术，对照组给予围手术期常规干预，研究组给予FTS理念的系统干预，术后均随访3个月。比较2组术后胃肠道功能恢复时间、急性疼痛、并发症及应激反应方面的差异。 结果研究组术后肠鸣音恢复时间、首次肛门排气时间、胃管拔除时间、进食时间及住院费用较对照组缩短/降低，差异均有统计学意义（P均<0.05）。术后第2天研究组和对照组平均NRS评分分别为（3.05±1.32）、（4.13±1.42）分；与对照组比较，研究组术后第2天NRS评分降低，且疼痛程度明显减轻，差异有统计学意义（P<0.05）。术后随访期间研究组恶心、呕吐、便秘及尿潴留发生率均低于对照组，差异均有统计学意义（P均<0.05）。 结论FTS理念的系统干预可促进行食管裂孔疝修补联合胃底折叠术的食管裂孔疝患者胃肠功能恢复，减轻患者疼痛程度，降低术后并发症的发生率。

Analysis of nursing effect of fast track surgery concept on patients undergoing esophageal hiatal hernia repair combined with fundoplication

ObjectiveTo investigate the nursing effect of fast track surgery (FTS) on patients undergoing esophageal hiatal hernia repair combined with fundoplication. MethodsFrom February 2017 to May 2018, 52 cases of esophageal hiatal patients were selected and divided into the study group (n=26) and the control group (n=26). The 2 groups were treated with esophageal hiatal hernia repair combined with fundoplication, and the control group was given routine intervention during the perioperative period. The study group was given the systematic intervention of the concept of FTS and followed up for 3 months. The differences of gastrointestinal function recovery time, acute and chronic pain, complications and stress reaction between the 2 groups were compared. ResultsThe recovery time of bowel sound, the first anus exhaust time, the extraction time of gastric tube, the time of feeding and the cost of hospitalization in the study group after operation were shorter than those of the control group (P<0.01). The average NRS score of the study group and the control group on the 2^nd day after operation was (3.05±1.32) and (4.13±1.42), respectively; Compared with the control group, the score of NRS in the study group decreased and the pain degree significantly reduced (P<0.01). The incidence of nausea, vomiting, constipation and retention of urine in the study group were lower than those in the control group (P<0.05 or P<0.01). ConclusionSystematic interventions based on the concept of FTS can accelerate the recovery of gastrointestinal function of esophageal hiatal patients undergoing esophageal hiatal hernia repair combined with fundoplication, reduce the degree of pain and the incidence of postoperative complications.