Effect of multi-dimensional nursing based on concept of fast track surgery in treatment of patients with laparoscopic myomectomy
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摘要: 目的 分析快通道外科(FTS)理念下多维度护理对腹腔镜子宫肌瘤剔除术(LM)患者的影响。 方法 选取行LM的子宫肌瘤患者96例,随机分为观察组(n=48)和对照组(n=48)。对照组予以常规治疗与护理,观察组采用FTS理念支持下的多维度护理,比较2组术后近期恢复情况、手术应激与营养指标［超敏C反应蛋白(hs-CRP)、白蛋白(Alb)、转铁蛋白(TRF)］、术后视觉模拟评分法(VAS)评分、简化舒适状况量表(GCQ)评分、并发症发生率。 结果 观察组术后肛门排气时间、下床活动时间、住院时间、医疗费用均短于、低于对照组,差异有统计学意义(P<0.05); 观察组术后3 d的hs-CRP低于对照组, Alb、TRF高于对照组,差异有统计学意义(P<0.05); 观察组术后1、3、7 d的VAS评分低于对照组,差异均有统计学意义(P<0.05); 观察组术后1个月GCQ总分及生理、社会文化、心理精神、环境维度得分均高于对照组,差异有统计学意义(P<0.05); 观察组术后3个月并发症发生率低于对照组,差异有统计学意义(P<0.05)。 结论 FTS理念下的多维度护理对缩短LM患者康复进程有益,能有效减轻手术应激反应,促进术后早期恢复,提高舒适度,降低并发症发生风险。Abstract: Objective To analyze effect of multi-dimensional nursing based on concept of fast track surgery(FTS)in the treatment of patients with laparoscopic myomectomy(LM). Methods Totally 96 patients with LM were randomly divided into observation group and control group, with 48 cases in each group. The control group was treated with routine treatment and nursing, while observation group was treated with multi-dimensional nursing based on FTS concept. The short-term postoperative recovery, surgical stress and nutritional indicators ［high sensitivity C-reactive protein(hs-CRP), albumin(Alb), transferrin(TRF)］, postoperative Visual Analogue Scale(VAS)score, Simplified Comfort Scale(GCQ)score and incidence of complications were compared between the two groups. Results The postoperative anal exhaust time, ambulation time, hospitalization time and medical expenses of the observation group were significantly shorter or lower than those of the control group(P<0.05). The hs-CRP of the observation group at 3 days after operation was significantly lower than that of the control group, while Alb and TRF levels were significantly higher than those of the control group(P<0.05). The VAS scores of the observation group at 1, 3, 7 d after operation were significantly lower than those of the control group(P<0.05). The total score of GCQ and the scores of physiology, - social culture, psychological spirit and environment dimensions in the observation group were significantly higher than those in the control group at 1 month after operation(P<0.05). The incidence of complications in the observation group at 3 months after operation was significantly lower than that in the control group(P<0.05). Conclusion Application of multi-dimensional nursing based on FTS concept is beneficial to shorten the rehabilitation process of patients with LM, which can effectively relieve the surgical stress, promote the early recovery after surgery, enhance comfortable degree and reduce the risk of complications.
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