快速康複外科護理在消化道術後恢複中的應用研究
護理研究
作者：唐彩萍等
[摘要] 目的 探討快速康複外科（fast track surgery，FTS）護理在行消化道手術的患者術後恢複中的應用。 方法 將74例消化道手術患者分為快速康複組和傳統護理組，每組37例。快速康複組圍手術期接受快速康複外科護理，傳統護理組接受傳統的圍手術期護理。觀察術後首次排氣、排便時間、營養狀況、術後住院時間、住院總費用及術後並發症等。 結果 兩組患者均痊愈出院，無一例死亡。與傳統手術相比，快速康複組術後患者住院總時間明顯縮短、住院總費用明顯減少、首次排氣及排便時間提前、營養狀況較好、總體並發症發生率明顯降低，且對醫護質量滿意度較好（P
[關鍵詞] 快速康複；外科護理；消化道術後；恢複
[中圖分類號] R730.76 [文獻標識碼] B [文章編號] 1673-9701（2015）09-0154-03
Application of fast track surgery nursing in recovery of gastrointestinal postoperative patients
TANG Caiping1 LI Yimin2
1.Department of Surgery，Branch of Zhejiang Hospital，Hangzhou 310030，China；2.No.1 People's Hospital of Hangzhou， Zhejiang Province， Hangzhou 310030，China
[Abstract] Objective To explore application of fast track surgery nursing of gastrointestinal postoperative patients recovery. Methods All 74 patients undergoing gastrointestinal operation were divided into FTS nursing group（37 cases） and traditional nursing group（37 cases）. The patients in FTS nursing group received fast track surgery perioperative nursing and the patients in traditional nursing group received traditional perioperative nursing. The time to first exhaust， first defecation， hospitalization after operation，nutritional status，the total cost of hospitalization，postoperative complications， and the satisfaction were observed. Results The patients of two groups recovered and discharged， and no cases died. The time to first exhaust， first defecation， and hospitalization after operation in FTS nursing group were significantly shorter than those in traditional nursing group. The total cost of hospitalization in FTS nursing group were significantly decreased than those in traditional nursing group. The nutritional status in FTS nursing group were better than those in traditional nursing group. The general postoperative complications in FTS nursing group were decreased than those in traditional nursing group. The satisfaction in FTS nursing group was better than that in traditional nursing group. There were statistically significant differences（P
[Key words] Fast track rehabilitation；Nursing of surgery；Gastrointestinal postoperative；Recovery
消化道手術由於手術創傷及術後營養等方麵的影響，術後患者往往在機體功能等方麵恢複較差，包括疼痛、消化功能紊亂及營養障礙等多方麵問題[1，2]。在圍手術期采取確實有效的措施加速其康複，能明顯改善患者的營養狀況、減輕疼痛、促進胃腸功能的恢複，避免相關並發症的發生、縮短住院時間，降低住院總費用，保障醫療安全，提高患者的滿意度。加速康複外科（fast track surgery，FTS）護理符合上述理念，其要求以患者為中心，采用一係列經循證醫學證實有效的圍術期優化措施以減少手術應激損害，維持患者內環境穩定，減輕患者心理和生理的應激反應，加快術後康複[3，4]。本研究以快速康複外科理念應用於消化道手術患者的圍手術期中，並以同期行傳統護理為對照，以證實其安全性和有效性。
1 資料與方法
1.1臨床資料
選擇2012年12月～2013年12月我院胃腸外科行消化道手術的患者74例，其中男41例，女33例，年齡31～72歲，平均（42.2±3.7）歲，手術涉及胃大部切除術、胃癌根治術、腹腔鏡膽囊切除術、胰十二指腸切除術、膽腸吻合術、左右半肝切除術、闌尾切除術、結直腸癌根治術等消化道手術。所有患者隨機分為快速康複外科護理組（FTS）37例和傳統護理組37例：FTS組年齡（42.9±4.2）歲，男21例，女16例；傳統護理組年齡（41.7±3.4）歲，男20例，女17例，兩組基本資料比較差異無統計學意義（P>0.05），具有可比性。