循证护理在患者行腹腔镜胆囊切除术后并发症中的应用研究(1)
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2010年5月1日
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【摘要】目的:探讨循证护理在预防患者行腹腔镜胆囊切除术后并发症中作用。方法:将80例行腹腔镜胆囊切除术的患者随机分成观察组(40例)和对照组(40例),观察组采用循证护理,对照组采用传统的护理方法,比较二者的护理效果。结果:观察组护理效果明显好于对照组,差异有统计学意义(P<0.05),如恶心和呕吐的发生率。结论:循证护理可以减少患者行腹腔镜胆囊切除术后并发症的发生,值得临床推广。
【关键词】循证护理;腹腔镜胆囊切除术;术后并发症;分析
doi:10.3969/j.issn.1006-1959.2010.05.013 文章编号:1006-1959(2010)-05-1039-02
Study on application of evidence based nursing for patients with postoperative complication after laparoscopic cholecystectomy LI Yu-ying The fouth People's Hospital of ZiYang,SiChuan.china 641300
【Abstract】Objective:To explore effect of evidence based nursing for patients with postoperative complication after laparoscopic cholecystectomy.Methods:80 cases patients with laparoscopic cholecystectomy were divided into the intervention group(40 cases) and control group(40 cases).The control group was applied for the traditional nursing method,the intervention group took the evidence based nursing, and then compared the nursing efficacy of them.Results:Comparing the results of two groups of patients,the nursing effect of intervention group was significantly higher than control group(P<0.05),such as the rate of nausea and vomiting.Conclusion:Evidence based nursing applied for patients after laparoscopic cholecystectomy significantly reduced the rate of postoperative complication,and hence is worthy of being recommended in clinical practice.
【Key words】Evidence based nursing;Laparoscopic cholecystectomy;Ppostoperative complication;Analysis
腹腔镜胆囊切除术是指在电视腹腔镜窥视下,将腹腔镜手术器械插入腹腔行胆囊切除术,具有视野清晰、手术操作简便、创伤小、痛苦轻、免缝合、恢复快、瘢痕小、术后恢复快和住院时间短等优点[1]。但是腹腔镜手术中因手术方式、麻醉用药及麻醉方法等因素的影响,术后常易发生并发症,如文献报道术后恶心、呕吐发生率可高达46%[2]。严重影响患者的术后的康复,所有,有效降低患者术后并发症的发生率具有积极的意义。2007年1月～2010年1月期间,为预防腹腔镜胆囊切除术后并发症的发生,我们采用循证护理,取得了满意护理效果,现报道如下。
1.资料与方法
1.1 一般资料:80例患者男29例,女51例,年龄22～75岁;择期手术74例,急诊手术6例;受教育时间1～20年。疾病类型:胆囊结石伴急性胆囊炎5例,结石性胆囊炎51例,慢性胆囊炎10例,胆囊息肉9例,胆囊癌5例。均在气管插管全身麻醉下施行腹腔镜胆囊切除术,取仰卧位,头高脚低10～15°,左斜15°,CO2气腹压力1.6～1.7kPa,手术时间为40min～90min,术中出血量10～50ml。术后均采用对症和抗感染治疗。80例患者随机分成观察组(40例)和对照组(40例),两组患者年龄、性别、受教育时间、疾病类型和手术情况等方面比较,差异无显著性(P>0.05),具有可比性,(见表1)。
表1 两组患者一般情况比较
组别性别比(男/女)年龄(岁)受教育时间(年)手术时间(min)术中出血量(ml)
观察组15/2548.2±4.68.9±2.350.6±10.928.7±5.2
对照组14/2648.5±4.89.1±2.153.4±10.229.0±5.1
P值>0.05>0.05>0.05>0.05>0.05
1.2 研究方法:观察组采用循证护理,对照组采用传统的护理方法,观察并记录患者手术24h内疼痛、恶心、呕吐以及术后皮下气肿、胆漏和腹腔内出血等并发症 ......
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