Clinical application effect of rapid rehabilitation surgical nursing technology in elderly patients undergoing ERCP
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摘要:
目的 探讨对于行经内镜逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography，ERCP)的老年患者应用快速康复外科护理的效果。 方法 选取2018年1月—2020年12月马鞍山市人民医院收治的110例老年胆总管结石患者(年龄≥60岁)，全部接受内镜下逆行胰胆管造影取石术。按照随机抽样分组，分为对照组和实验组，对照组55例接受常规性护理，实验组55例接受快速康复外科护理。比较2组手术成功率、手术时间、住院时间、手术并发症发生率、术后疼痛评分、临床护理服务满意率等指标的差异。 结果 实验组平均手术时间[(34.5±8.2)min]低于对照组[(39.5±10.5)min], 平均住院时间[(8.5±2.0)d]低于对照组[(9.9±2.5)d], 术后疼痛评分[(2.02±0.76)分]低于对照组[(2.56±0.78)分]，差异有统计学意义(均P＜0.05)。实验组手术成功率为96.4%, 高于对照组(90.9%)，手术并发症发生率为7.3%，低于对照组(16.4%)，但两者差异均无统计学意义(均P＞0.05)；实验组患者的临床护理服务满意率(94.5%)高于对照组(80.0%)，差异有统计学意义(P＜0.05)。 结论 快速康复外科护理可以保证老年患者ERCP术的成功率，降低术后疼痛评分，缩短手术时间及住院时间，全面提升临床护理服务满意率及护理管理质量。 -
关键词:
- 快速康复外科护理 /
- 胆总管结石 /
- 经内镜逆行性胰胆管造影术
Abstract:Objective To investigate the effect of rapid rehabilitation surgical nursing on elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 110 elderly patients (aged ≥ 60 years) with common bile duct stones who were admitted and underwent ERCP at Maanshan People's Hospital from January 2018 to December 2020 were included in this study. The patients were randomly divided into the control and experimental groups. A total of 55 cases in the control group received routine nursing, and 55 cases in the experimental group received rapid rehabilitation surgical nursing. The differences of clinical indicators such as operation success rate, operation time, hospital stay, incidence of operation complications, postoperative pain score and satisfaction rate of clinical nursing service in both groups were compared. Results The operation time[(34.5±8.2) min], hospitalisation time[(8.5±2.0) days] and postoperative pain score [(2.02±0.76) points] in the experiment group were significantly shorter than those in the control group[(39.5±10.5) min, (9.9±2.5) days and (2.56±0.78) points, respectively, all P < 0.05]. The experiment group had higher surgical success rate and lower operative complications than the control group (96.4% vs. 90.9%, 7.3% vs. 16.4%, respectively, all P > 0.05). The satisfaction rate of clinical nursing service in the experimental group (94.5%) was higher than that in the control group (80.0%), and the difference was statistically significant (P < 0.05). Conclusion Rapid rehabilitation surgical nursing can ensure the success rate of ERCP in elderly patients, reduce postoperative pain score, shorten operation time and hospital stay, and comprehensively improve the satisfaction rate of clinical nursing service and the quality of nursing management. -
表 1 2组患者手术成功率、并发症、手术时间、住院时间比较
Table 1. Comparison of surgical success rate, surgical complications, surgical time and hospitalization time between the two groups
组别 例数 手术成功[例(%)] 并发症[例(%)] 手术时间(x±s，min) 住院时间(x±s，d) 对照组 55 50(90.9) 9(16.4) 39.5±10.5 9.9±2.5 实验组 55 53(96.4) 4(7.3) 34.5±8.2 8.5±2.0 统计值 0.610a 2.161a 2.783b 3.243b P值 0.435 0.142 0.006 0.002 注：a为χ2值；b为t值。 
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表 2 2组患者术前及术后24 h VRS疼痛评分比较(x±s，分)
Table 2. Comparison of VRS pain scores before and 24 hours after operation between the two groups (x±s, score)
组别 例数 VRS疼痛评分 t值 P值 术前 术后24 h 对照组 55 1.65±0.64 2.56±0.78 10.351 ＜0.001 实验组 55 1.55±0.57 2.02±0.76 1.247 0.093 t值 0.865 3.677 P值 0.389 ＜0.001
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表 3 2组患者临床护理服务满意率比较[例(%)]
Table 3. Comparison of satisfaction rate of clinical nursing service between two groups [cases (%)]
组别 例数 满意 基本满意 不满意 总体满意 对照组 55 32(58.2) 12(21.8) 11(20.0) 44(80.0) 实验组 55 43(78.2) 9(16.3) 3(5.5) 52(94.5) 注：2组总体满意率比较，χ2=5.191, P=0.023。
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