循證護理在腹腔鏡膽囊闌尾聯合切除圍術期效果觀察

[摘要] 目的 探討循證護理在腹腔鏡膽囊闌尾聯合切除圍術期效果情況。方法 方便選取并分析河源市龍川縣人民醫院普外科2014年1月—2015年2月診治的400例腹腔鏡膽囊闌尾聯合切除術患者臨床資料，依據是否實施循證護理進行分組，對照組（實施常規護理措施組）200例和循證護理組（實施循證護理措施組）200例。觀察兩組腹腔鏡膽囊闌尾聯合切除術患者術后疼痛持續時間情況、術后出血、膽汁漏、肩背部酸痛、殘端瘺發生率情況。結果 循證護理組腹腔鏡膽囊闌尾聯合切除術患者術后疼痛持續時間<12 h、術后疼痛持續時間12～24 h、術后疼痛持續時間>24 h評分均低于對照組，循證護理組術后出血、膽汁漏、肩背部酸痛、殘端瘺發生率均低于對照組，P<0.05，差異均有統計學意義。結論 循證護理在腹腔鏡膽囊闌尾聯合切除圍術期應用，可以明顯降低術后疼痛持續時間和并發癥，值得臨床推廣應用。

[關鍵詞] 循證護理；腹腔鏡；膽囊闌尾聯合切除；圍術期

[中圖分類號] R47 [文獻標識碼] A [文章編號] 1674-0742（2016）10（b）-0171-03

[Abstract] Objective To approach result of laparoscope gallbladder appendix combined resection in the perioperative period by evidence-based nursing. Methods Convenient selection 400 cases clinical data of laparoscope gallbladder appendix combined resection patients in general surgery department people hospital of Heyuan city Longchuan town from January 2014 February 2015 were analyzed，which was to be divided into two groups，control group（conventional nursing measures group）200 cases and evidence-based nursing group（evidence-based nursing measures group）200 cases.The pain duration time after operation、bleeding after operation、bile leakage、humeral back ache、stump fistula rate of two groups laparoscope gallbladder appendix combined resection patients were detection. Results The pain duration time after operation<12 h、pain duration time after operation12～24 h、pain duration time after operation>24 h score of evidence-based nursing group laparoscope gallbladder appendix combined resection patients were lower than control group，the bleeding after operation、bile leakage、humeral back ache、stump fistula rate of evidence-based nursing group laparoscope gallbladder appendix combined resection patients were lower than control group，P<0.05，the difference were statistical significance. Conclusion The application of laparoscope gallbladder appendix combined resection in the perioperative period by evidence-based nursing，which could decrease pain duration time after operation and complication，it is worth to be used.

[Key words] Evidence-based nursing；Laparoscope；Gallbladder appendix combined resection；Perioperative period

腹腔鏡膽囊闌尾聯合切除術可以同時治療膽囊和闌尾兩個器官的疾病，在臨床得到了廣泛的應用，同時具有微創傷、出血少、恢復快等優點，可以在一次麻醉情況下，對闌尾和膽囊同時切除，避免了二次麻醉、二次手術帶來的痛苦[1-2]。但是腹腔鏡膽囊闌尾聯合切除術畢竟屬于創傷性手術，其也具有相應的并發癥，目前針對腹腔鏡膽囊闌尾聯合切除圍術期護理的研究雖然較多，但是多數集中在常規的護理措施上[3-4]。……