Li Sha, Bai Jing, Wei Wanxia, Liu Xiaoqin, Shen Yanping
Department of Anesthesiology and Surgery, Affiliated Hospital of Gansu University of Chinese Medicine Lanzhou 730020, Gansu Province, China.
Department of Nursing, Affiliated Hospital of Gansu University of Chinese Medicine Lanzhou 730020, Gansu Province, China.
Am J Transl Res. 2021 Aug 15;13(8):9647-9654. eCollection 2021.
To explore the effect of systematic nursing on the stress response and recovery of gastrointestinal function in patients undergoing laparoscopic cholecystectomy.
A retrospective study was conducted among 102 patients with gallbladder system disease. They were divided into an observation group (n=51, perioperative systematic care) and a control group (n=51, perioperative conventional care) according to a random number table. The clinical indicators, postoperative recovery of gastrointestinal function, and patients' stress response, psychological status and quality of life before and after intervention were compared between the two groups.
Compared with the control group, the time to get out of bed for the first time after operation, the recovery time of bowel sounds, and the time of first gas/defecation after operation in the observation group were significantly earlier (all P<0.01), and the hospital stay was significantly shorter (P<0.001). Compared with 12 hours before operation, the serum adrenaline and cortisol levels of the two groups were significantly higher at 48 hours after operation, and the levels in the observation group were lower than the control group (all P<0.001). Compared with 1 day before the operation, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in both groups were reduced when they were discharged from the hospital, and the scores in the observation group were lower than that of the control group (all P<0.01). Three months after the operation, the scores of Generic Quality of Life Inventory-74 (GQOLI-74) in the two groups increased in all dimensions, and the scores in the observation group were higher than the control group (all P<0.05).
Systematic care during the perioperative period of laparoscopic cholecystectomy can alleviate the degree of stress, promote the recovery of postoperative gastrointestinal function, relieve the level of anxiety and depression, and improve the quality of life of patients after discharge from the hospital.
探讨系统护理对腹腔镜胆囊切除术患者应激反应及胃肠功能恢复的影响。
对102例胆囊系统疾病患者进行回顾性研究。根据随机数字表将其分为观察组（n = 51，围手术期系统护理）和对照组（n = 51，围手术期常规护理）。比较两组的临床指标、术后胃肠功能恢复情况以及干预前后患者的应激反应、心理状态和生活质量。
与对照组相比，观察组术后首次下床时间、肠鸣音恢复时间及术后首次排气/排便时间均显著提前（均P < 0.01），住院时间显著缩短（P < 0.001）。与术前12小时相比，两组术后48小时血清肾上腺素和皮质醇水平均显著升高，且观察组低于对照组（均P < 0.001）。与术前1天相比，两组出院时汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分均降低，且观察组低于对照组（均P < 0.01）。术后3个月，两组生活质量综合评定问卷-74（GQOLI - 74）各维度评分均升高，且观察组高于对照组（均P < 0.05）。
腹腔镜胆囊切除术围手术期的系统护理可减轻应激程度，促进术后胃肠功能恢复，缓解焦虑和抑郁水平，提高患者出院后的生活质量。
