Influence of FTS concept based on Chinese medicine characteristics on comfort and postoperative recovery of patients undergoing laparoscopic cholecystectomy
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摘要:
目的 探究腹腔镜胆囊切除术患者实施中医特色快速康复外科(FTS)理念指导的护理效果及对患者舒适度、术后恢复的影响。 方法 选取2020年7月—2022年10月在台州市中西医结合医院接受腹腔镜胆囊切除术的180例患者为研究对象，按照随机数字表法分为对照组(90例)与观察组(90例)，分别采用快速康复外科护理与基于中医特色快速康复外科护理，比较2组临床相关指标、负性情绪及睡眠质量、日常生活能力与并发症发生情况。 结果 观察组首次下床活动时间、排气时间、排便时间、住院时间均短于对照组[(6.51±1.25)h vs. (7.86±1.92)h; (23.33±7.46)h vs.(27.22±8.55)h; (1.89±0.54)d vs.(2.91±0.92)d; (2.32±0.04)d vs.(2.87±0.25)d，均P＜0.05]。干预后，观察组焦虑自评量表评分、抑郁自评量表评分、匹兹堡睡眠质量指数均低于对照组(均P＜0.05)，日常生活能力评分高于对照组[(82.54±5.15)分vs. (78.45±5.26)分]。观察组并发症发生率为5.56%(5/90)，低于对照组[15.56%(14/90)，P＜0.05]。 结论 基于中医特色快速康复外科理念可有效促进腹腔镜胆囊切除术患者术后康复，缓解负性情绪，改善睡眠质量，提高日常生活能力，降低并发症发生风险，进而明显提升患者术后的舒适度。 Abstract:Objective To investigate the nursing effect of laparoscopic cholecystectomy patients guided by fast track surgery (FTS) concept with traditional chinese medicine (TCM) characteristics and its influence on patients ' comfort level and postoperative recovery. Methods A total of 180 patients who underwent laparoscopic cholecystectomy at Taizhou Integrated Traditional Chinese and Western Medicine Hospital from July 2020 to October 2022 were selected as the research subjects, and were divided into control group (90 cases) and observation group (90 cases) according to random number table method. Rapid rehabilitation surgical nursing and rapid rehabilitation surgical nursing based on the characteristics of TCM were respectively adopted. Clinical indicators, negative emotions, sleep quality, activities of daily living and complication rates were compared between the two groups. Results The time of first activity out of bed, exhaust time, defecation time and hospitalization time in the observation group were all shorter than those in the control group [(6.51?.25) h vs. (7.86?.92) h, (23.33?.46) h vs. (27.22?.55) h, (1.89?.54) d vs. (2.91?.92) d, (2.32?.04) d vs. (2.87?.25) d, all P < 0.05]. After the intervention, scores on the self-rating anxiety scale, the self-rating depression scale and Pittsburgh sleep quality index in the observation group were lower than those in the control group (all P < 0.05), and the score of daily living ability was higher than that in the control group [(82.54?.15) points vs. (78.45?.26) points]. The incidence of complications in the observation group was 5.56% (5/90), which was lower than 15.56% (14/90) in the control group (P < 0.05). Conclusion Based on the concept of TCM characteristics, it can effectively promote the postoperative rehabilitation of patients with laparoscopic cholecystectomy, relieve negative emotions, improve sleep quality, improve daily living ability, reduce the risk of complications, and significantly improve the comfort level of patients after surgery. -
表 1 2组腹腔镜胆囊切除术患者临床指标比较(x±s)
Table 1. Comparison of clinical indexes between the two groups of patients undergoing laparoscopic cholecystectomy (x±s)
组别 例数 首次下床活动时间(h) 首次排气时间(h) 首次排便时间(d) 住院时间(d) 对照组 90 7.86±1.92 27.22±8.55 2.91±0.92 2.87±0.25 观察组 90 6.51±1.25 23.33±7.46 1.89±0.54 2.32±0.04 t值 5.590 3.252 9.071 20.609 P值 ＜0.001 0.001 ＜0.001 ＜0.001 
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表 2 2组腹腔镜胆囊切除术患者负性情绪及睡眠质量比较(x±s，分)
Table 2. Comparison of negative emotions and sleep quality between the two groups of patients undergoing laparoscopic cholecystectomy (x±s, points)
组别 例数 SAS SDS PSQI 干预前 干预后 干预前 干预后 干预前 干预后 对照组 90 56.22±4.83 44.34±5.13a 59.72±6.12 48.16±8.11a 28.94±1.51 17.68±1.89a 观察组 90 55.54±5.38 40.35±7.41a 58.33±5.35 42.28±7.33a 29.26±1.68 13.92±1.77a t值 0.892 4.200 1.622 5.103 1.344 13.776 P值 0.373 ＜0.001 0.107 ＜0.001 0.181 ＜0.001 注：与干预前比较，aP＜0.05。
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表 3 2组腹腔镜胆囊切除术患者日常生活能力比较(x±s，分)
Table 3. Comparison of daily living ability between two groups of patients undergoing laparoscopic cholecystectomy (x±s, points)
组别 例数 干预前 干预后 t值 P值 对照组 90 60.33±4.37 78.45±5.26 193.148 ＜0.001 观察组 90 59.71±4.22 82.54±5.15 232.886 ＜0.001 t值 0.968 5.271 P值 0.334 ＜0.001
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表 4 2组腹腔镜胆囊切除术患者并发症比较[例(%)]
Table 4. Comparison of complications between two groups of patients undergoing laparoscopic cholecystectomy [cases (%)]
组别 例数 穿刺处皮下出血或感染 胆漏 压疮 总发生 对照组 90 9(10.00) 2(2.22) 3(3.33) 14(15.56) 观察组 90 3(3.33) 1(1.11) 1(1.11) 5(5.56) 注：2组并发症总发生率比较，χ2=4.739，P=0.029。
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[1] 王亚珂, 张晓慧. 腹腔镜胆囊切除术对胆结石患者胃肠功能及应激反应的影响[J]. 医药论坛杂志, 2021, 42(7): 107-110. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYX202107027.htmWANG Y K, ZHANG X H. Effect of laparoscopic cholecystectomy on gastrointestinal function and stress response in patients with gallstones[J]. Journal of Medical Forum, 2021, 42(7): 107-110. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYX202107027.htm [2] 王海红, 刘梅, 郭春玲, 等. 快速康复外科理念在腹腔镜胆囊切除术患者中的应用[J]. 齐鲁护理杂志, 2021, 27(24): 125-127. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202124050.htmWANG H H, LIU M, GUO C L, et al. The application of the concept of rapid rehabilitation surgery in patients undergoing laparoscopic cholecystectom[J]. Journal of Qilu Nursing, 2021, 27(24): 125-127. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202124050.htm [3] 黄娟, 杨颖, 张少群, 等. 中医封包技术联合FTS理念对妇科腹腔镜术后胃肠功能恢复的效果[J]. 国际护理学杂志, 2021, 40(18): 3326-3330.HUANG J, YANG Y, ZHANG S Q, et al. Effect of traditional Chinese medicine packaging technology combined with FTS concept on gastrointestinal function recovery after gynecological laparoscopic surgery[J]. International Journal of Nursing, 2021, 40(18): 3326-3330. [4] 王征宇, 迟玉芬. 焦虑自评量表(SAS)[J]. 上海精神医学, 1984(2): 73-74. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402008.htmWANG Z Y, CHI Y F. Self-rating anxiety scale (SAS)[J]. Shanghai Psychiatry, 1984(2): 73-74. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402008.htm [5] 王征宇, 迟玉芬. 抑郁自评量表(SDS)[J]. 上海精神医学, 1984(2): 71-72. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402007.htmWANG Z Y, CHI Y F. Self-rating depression scale (SDS)[J]. Shanghai Psychiatry, 1984(2): 71-72. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402007.htm [6] 王燕, 李潇. 情志护理联合缩唇-腹式呼吸训练对难治性慢性心力衰竭伴睡眠障碍患者匹兹堡睡眠质量指数、不良情绪、心功能和生活质量的影响[J]. 现代中西医结合杂志, 2019, 28(34): 3858-3862. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201934025.htmWANG Y, LI X. The effect of emotional nursing combined with lip-abdominal breathing training on Pittsburgh sleep quality index, bad mood, cardiac function and quality of life in patients with refractory chronic heart failure and sleep disorder[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2019, 28(34): 3858-3862. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201934025.htm [7] 陈铁炯, 郑军. 腹腔镜联合胆道镜与传统开腹手术治疗胆囊结石合并胆总管结石临床对比分析[J]. 中华全科医学, 2018, 16(2): 226-228. doi: 10.16766/j.cnki.issn.1674-4152.000063CHEN T J, ZHENG J. Clinical comparative analysis of laparoscopic combined choledochoscope and traditional open surgery in the treatment of cholecystolithiasis complicated with choledocholithiasis[J]. Chinese Journal of General Practice, 2018, 16(2): 226-228. doi: 10.16766/j.cnki.issn.1674-4152.000063 [8] 潘国芬, 胡梦瑶, 柏祥云, 等. 肝细胞肝癌经肝动脉灌注化疗栓塞术后快速康复外科理念康复的研究[J]. 中华保健医学杂志, 2022, 24(4): 287-290. https://www.cnki.com.cn/Article/CJFDTOTAL-JFJB202204009.htmPAN G F, HU M Y, BAI X Y, et al. Rehabilitation of FTS concept in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization[J]. Chinese Journal of Health Care and Medicine, 2022, 24(4): 287-290. https://www.cnki.com.cn/Article/CJFDTOTAL-JFJB202204009.htm [9] 王晓艳, 宋西艳, 魏华. FTS理念对骨折手术患者机体应激反应、骨折愈合进程的影响[J]. 检验医学与临床, 2020, 17(10): 1417-1420. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202010032.htmWANG X Y, SONG X Y, WEI H. Effect of FTS idea on body stress response and fracture healing progress in patients with fracture surgery[J]. Laboratory Medicine and Clinic, 2020, 17(10): 1417-1420. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202010032.htm [10] 曹玉华, 陈玉旋, 李丹. 快速康复外科干预对老年患者腹腔镜胃癌根治术后应激反应、细胞免疫功能和生活质量的影响[J]. 中国医学前沿杂志(电子版), 2020, 12(1): 137-140. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY202001027.htmCAO Y H, CHEN Y X, LI D. Effects of fast track surgery intervention on stress response, cellular immune function and quality of life in elderly patients undergoing laparoscopic radical gastrectomy[J]. Chinese Journal of Medical Frontiers (electronic edition), 2020, 12(1): 137-140. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY202001027.htm [11] 史迎春, 王元, 陈兰, 等. FTS理念在腹腔镜全子宫切除术围手术期的护理效果[J]. 中国医药导报, 2021, 18(35): 174-176. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202135042.htmSHI Y C, WANG Y, CHEN L, et al. Nursing effect of FTS concept in perioperative period of laparoscopic total hysterectomy[J]. China Medical Herald, 2021, 18(35): 174-176. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202135042.htm [12] 魏成侠, 卢根娣, 倪惠, 等. 卒中后认知障碍病人的中医特色护理研究进展[J]. 护理研究, 2022, 36(2): 249-253. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202202011.htmWEI C X, LU G D, NI H, et al. Research progress of traditional Chinese medicine characteristic nursing of patients with post-stroke cognitive impairment[J]. Chinese Nursing Research, 2022, 36(2): 249-253. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202202011.htm [13] 王水芳, 夏炳江. 以循证理论为基础的中医特色护理对股骨头坏死患者生活质量及治疗效果的影响[J]. 中华全科医学, 2021, 19(2): 328-331. doi: 10.16766/j.cnki.issn.1674-4152.001801WANG S F, XIA B J. Effect of TCM characteristic nursing based on evidence-based theory on the quality of life and therapeutic effect of patients with femoral head necrosis[J]. Chinese Journal of General Practice, 2021, 19(2): 328-331. doi: 10.16766/j.cnki.issn.1674-4152.001801 [14] 刘军霞, 闫河峰, 梁晓萌. 整体干预模式对膀胱癌患者围手术期心理应激反应的影响[J]. 癌症进展, 2022, 20(1): 100-103. https://www.cnki.com.cn/Article/CJFDTOTAL-AZJZ202201021.htmLIU J X, YAN H F, LIANG X M. Effect of the general intervention model on the psychological stress response in the perioperative period of bladder cancer surgery[J]. Oncology Progress, 2022, 20(1): 100-103. https://www.cnki.com.cn/Article/CJFDTOTAL-AZJZ202201021.htm [15] 闫延, 程崇杰, 张启栋, 等. 骨科手术相关创伤后应激障碍的发生及高危因素分析[J]. 中国组织工程研究, 2020, 24(24): 3897-3903. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202024024.htmYAN Y, CHENG C J, ZHANG Q D, et al. Occurrence and high risk factors of post-traumatic stress disorder related to orthopedic surgery[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(24): 3897-3903. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202024024.htm [16] 盖楠楠, 薛琳, 吴鹏, 等. 中药封包联合穴位贴敷对不同证型膝骨性关节炎的临床治疗效果分析[J]. 检验医学与临床, 2022, 19(1): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202201023.htmGAI N N, XUE L, WU P, et al. Analysis of clinical therapeutic effect of traditional Chinese medicine packaging combined with acupoint application on knee osteoarthritis of different syndrome types[J]. Laboratory Medicine and Clinic, 2022, 19(1): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202201023.htm [17] 唐源, 刘萍, 高俊芳, 等. 加速康复外科对喉癌手术患者术后快速恢复、应激反应和并发症的影响[J]. 临床与病理杂志, 2022, 42(8): 1885-1891. https://www.cnki.com.cn/Article/CJFDTOTAL-WYSB202208016.htmTANG Y, LIU P, GAO J F, et al. Effect of enhanced recovery after surgery concept on postoperative rapid recovery, stress response, and complications in patients with laryngeal cancer surgery[J]. Journal of Clinical and Pathological Research, 2022, 42(8): 1885-1891. https://www.cnki.com.cn/Article/CJFDTOTAL-WYSB202208016.htm [18] 刘敏, 王琦, 陈艳. 自录制护理教育视频在腹腔镜胆囊切除术患者中的应用[J]. 齐鲁护理杂志, 2021, 27(10): 132-134. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202110057.htmLIU M, WANG Q, CHEN Y. Application of self-recorded nursing education video in patients undergoing laparoscopic cholecystectomy[J]. Journal of Qilu Nursing, 2021, 27(10): 132-134. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202110057.htm [19] 肖潇, 汪曲兴, 夏雯. 使用与满足理论在腹腔镜胆囊切除术患者延续性护理中的应用[J].齐鲁护理杂志, 2022, 28(4): 139-142. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202204048.htmXIAO X, WANG Q X, XIA W. Application of the theory of use and satisfaction in the continuous care of patients undergoing laparoscopic cholecystectomy[J].Journal of Qilu Nursing,2022,28(4):139-142. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202204048.htm -
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