摘要
目的探讨加速康复外科围术期管理模式对肝内外胆管结石患者术后康复效果的有效性及安全性。方法收集2016年1-12月四川大学华西医院胆道外科中心收治的100例肝内外胆管结石患者(ERAS组),围术期均采用加速康复外科围术期管理方案进行管理;同时收集2015年1-12月收治的88例肝内外胆管结石患者(传统组),围术期采用传统的诊疗护理常规进行管理,对比分析两组患者的临床资料,比较两组患者术后早期康复效果、并发症发生率、住院时间及患者满意度等指标。结果术后早期康复效果方面,ERAS组术后首次排气时间早于传统组[(30.35±10.24)h vs.(70.69±11.23)h,P<0.05],ERAS组术后72h以内的疼痛评分低于传统组[(2.56±1.12)分vs.(5.61±2.51)分,P<0.05];两组患者术后30d非计划性再入院率差异无统计学意义(P>0.05)。术后并发症方面,ERAS组患者并发症总发生率更低(8.00%vs.18.18%,P<0.05),但两组患者在各项并发症发生率上差异无统计学意义(P>0.05)。经济效益方面,ERAS组患者平均住院时间及术后住院时间均短于传统组(P<0.05),患者满意度更高(P<0.05)。结论加速康复外科围术期管理模式能够促进患者术后的早期加速康复,降低并发症发生率,能缩短住院时间,改善患者就医体验,提升医疗服务质效。
Objective To evaluate the effectiveness and safety of fast-track surgery perioperative management mode on postoperative rehabilitation effects in the patients with intrahepatic and extrahepatic bile duct stones.Methods A total of 100 patients with intrahepatic and extrahepatic bile duct stones(ERAS group)in the Biliary Surgery Center of West China Hospital of Sichuan University from January to December 2016 were collected and adopted the fast-track surgery perioperative management scheme for conducting the management;at the same time 88 cases of intrahepatic and extrahepatic bile duct stones(traditional group)from January to December 2015 were collected and adopted the traditional diagnosis and treatment nursing routine for conducting the management.The clinical data in the two groups were performed the comparative analysis,including early rehabilitation effect,complication occurrence rate,length of hospitalization,hospitalization costs,patient satisfaction,etc.Results In the aspect of early postoperative rehabilitation,the first exhaust time in the ERAS group was earlier than that in the traditional group[(30.35±10.24)h vs.(70.69±11.23)h,P<0.05].The pain score within postoperative 72 h in the ERAS group was lower than that in the traditional group[(2.56±1.12)min vs.(5.61±2.51)min,P<0.05)];the the postoperative 30 d non-planned re-admission rate had no statistically significant difference between the two groups(P>0.05).In the aspect of postoperative complications,the incidence rate of complications in the ERAS group was much less(8.00%vs.18.18%,P<0.05),but there was no statistically significant difference in the incidence rate of each complication between the two groups(P>0.05).In the aspect of economic effectiveness,the average hospitalization time and postoperative hospitalization time in the ERAS group were shorter than those in the traditional group(P<0.05),and the patient satisfaction was much higher(P<0.05).Conclusion The fast-track surgery perioperative management mode can promote the early accelerated recovery after surgery,decreases the occurrence rate of complications,shortens the hospitalization duration,improves the experience of seeing doctor and increases the quality and effect of medical service.
作者
冯金华
许瑞华
李卡
冯缓
韩蔷
FENG Jinhua;XU Ruihua;LI Ka;FENG Huan;HAN Qiang(Department of Biliary Surgery,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China;Department of Nursing,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China)
出处
《重庆医学》
CAS
2018年第21期2777-2780,2785,共5页
Chongqing medicine
基金
四川省卫生和计划生育委员会支撑项目(17PJ303)
四川大学华西医院学科卓越发展1.3.5工程项目(ZY2016204)
关键词
治疗结果
经济学
医学
加速康复外科
肝内外胆管结石
围术期管理
treatment outcome
economics,medical
fast-track surgery
intrahepatic and extrahepatic bile duct stones
perioperative management
作者简介
冯金华(1990-),护师,硕士,主要从事外科临床护理研究。;许瑞华,通信作者:,E-mail:xrh-lr@163.com。
