Effect of Nurse-led Nursing Model in Patients with Laparoscopic Hepatectomy
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摘要:
目的 探讨护士主导的护理模式在腹腔镜肝切除患者中的应用效果。 方法 选取2021年01~12月120例,行腹腔镜肝切除患者作为研究对象,采用随机数字表法分为观察组和对照组各60例,观察组实施以护士为主导的护理模式,对照组实施常规整体护理模式。比较2组患者术前与术后肝功能指标、术后并发症(出血、胆漏、腹水、腹胀)、术后下床活动时间、进食时间、肛门排气排便时间、腹腔引流管拔除时间、住院时间、术后疼痛评分、自理能力评分、住院满意度。 结果 除观察组与对照组术前肝功能指标,差异无统计学意义(P > 0.05)外,其余各项指标均优于对照组,差异有统计学意义(P < 0.05)。 结论 将护士主导的护理模式应用于腹腔镜肝切除围手术期,可加速患者康复、减少并发症发生、缩短住院时间、提高自理能力,提升治疗效果与住院满意度,有临床应用价值。 Abstract:Objective To explore the effect of nurse-led nursing mode in laparoscopic hepatectomy. Methods A total of 120 patients who underwent laparoscopic hepatectomy from January to December 2021 were selected as the research objects, and were divided into observation group and control group with 60 patients in each group by random number table method. The observation group received nurse-led nursing mode, and the control group received conventional holistic nursing mode. Preoperative and postoperative liver function indexes, postoperative complications(bleeding, biliary leakage, ascites, abdominal distension), postoperative ambulation time, feeding time, anal exhaust and defecation time, abdominal drainage tube removal time, length of hospital stay, postoperative pain score, self-care ability score, and hospitalization satisfaction were compared between the two groups. Results There was no significant difference in preoperative liver function between the observation group and the control group(P > 0.05). The other indicators were better than the control group, with statistical significance(P < 0.05). Conclusion The application of nurse-led nursing mode in the perioperative period of laparoscopic hepatectomy can accelerate patients' recovery, reduce complications, shorten hospital stay, improve self-care ability, improve treatment effect and hospitalization satisfaction, and has clinical application value. -
Key words:
- Nurse-led nursing mode /
- Laparoscopic hepatectomy /
- Rapid recovery
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表 1 2组患者术前术后肝功能指标比较(
$\bar x \pm s $ )Table 1. Comparison of preoperative and postoperative liver function indexes between two groups (
$\bar x \pm s $ )组别 n ALT(IU/L) AST(IU/L) TBIL(μmol/L) ALB(g/L) 术前 术后 术前 术后 术前 术后 术前 术后 观察组 60 34.11 ± 32.35 138.63 ± 134.86* 34.95 ± 22.43 80.96 ± 94.33* 16.21 ± 8.71 18.50 ± 10.83* 45.27 ± 2.52 37.72 ± 3.44* 对照组 60 33.50 ± 18.25 207.84 ± 156.46 34.39 ± 17.60 204.20 ± 150.13 18.41 ± 21.08 24.85 ± 19.83 45.21 ± 2.64 34.95 ± 4.62 t 0.127 −2.60 0.151 −5.38 −0.749 −2.18 0.11 3.73 P > 0.05 0.01 > 0.05 0.00 > 0.05 0.032 > 0.05 0.00 与对照组比较,*P < 0.05。 表 2 2组患者术后并发症(出血、胆漏、腹水、腹胀)比较(n)
Table 2. Comparison of postoperative complications ( bleeding,bile leakage,ascites,abdominal distension ) between the two groups (n)
组别 n 出血 胆漏 腹水 腹胀 观察组 60 0* 0 3* 5* 对照组 60 4 2 10 13 χ2 4.14 2.03 4.23 4.18 P 0.04 0.15 0.04 0.04 与对照组比较,*P < 0.05。 表 3 2组患者术后下床活动时间、进食时间、肛门排气排便时间、拔出腹腔引流管时间、住院时间比较(
$\bar x \pm s $ )Table 3. Comparison of postoperative ambulation time,eating time,anal exhaust defecation time,abdominal drainage tube extraction time and hospitalization time between the two groups (
$\bar x \pm s $ )组别 n 下床活动时间(h) 进食时间(h) 肛门排气排便时间(h) 拔出腹腔引流管时间(h) 住院时间(d) 观察组 60 22.73 ± 7.59* 15.67 ± 4.03* 19.00 ± 3.31* 39.00 ± 12.87* 7.59 ± 0.83* 对照组 60 35.38 ± 11.27 27.92 ± 8.01 30.05 ± 6.46 44.12 ± 13.27 8.87. ± 1.19 t −7.21 −10.58 −11.80 −2.14 −6.82 P 0.00 0.00 0.00 0.035 0.00 与对照组比较,*P < 0.05。 表 4 2组患者术后3 d疼痛评分、自理能力评分、住院医护满意度(
$\bar x \pm s $ )Table 4. The pain score,self-care ability score and hospital satisfaction of patients in 2 groups 3 days after surgery (
$\bar x \pm s $ )组别 n 术后疼痛
评分术后自理
能力评分医护满
意度(%)观察组 60 1.53 ± 0.91* 85.08 ± 6.21* 95.92 ± 3.11* 对照组 60 2.10 ± 1.42 74.42 ± 6.90 86.27 ± 4.59 t −2.60 8.91 13.49 P 0.01 0.00 0.00 与对照组比较,*P < 0.05。 -
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