CAJ | 학술논문

　　目的：探讨快通道外科技术在综合外科围手术期中应用的护理效果。方法：将192例患者分为对照组和观察组两组，对照组96例手术患者按常规护理；观察组96例手术患者应用快通道外科技术进行术前积极的心理护理、详细的健康教育和有效的交流，适当补充场内营养，不常规灌肠、不常规留置胃管尿管，缩短禁食、禁饮时间；术中严格控制输液量及盐水入量、充足吸氧、预防性应用抗生素、选择较好的手术方式最佳的麻醉方法及切口模式、合理调节室温并有效保暖、不常规放置腹部引流管；术后联合镇痛、早期肠内营养、尽早拔除腹部引流管尿管、早期功能锻炼和下床活动。结果：观察组96例手术患者在病情知晓率、护理配合程度、满意度调查方面较对照组明显提高，术后肛门排气排便时间较对照组提前，没有出现恶心呕吐、发热、误吸、肺部感染、静脉栓塞、切口感染等并发症，只有1例吻合口瘘，大大缩短了住院时间、降低了医疗费用。结论：应用快通道外科技术对手术患者进行围手术期护理，能更合理有效地控制患者的病理生理变化，减少了机体对手术所产生的应激和炎症反应，明显减少了并发症，加快了术后康复的速度，减轻了社会、医院及患者家庭的经济负担，值得推广。
　　목적：탐토쾌통도외과기술재종합외과위수술기중응용적호리효과。방법：장192례환자분위대조조화관찰조량조，대조조96례수술환자안상규호리；관찰조96례수술환자응용쾌통도외과기술진행술전적겁적심리호리、상세적건강교육화유효적교류，괄당보충장내영양，불상규관장、불상규류치위관뇨관，축단금식、금음시간；술중엄격공제수액량급염수입량、충족흡양、예방성응용항생소、선택교호적수술방식최가적마취방법급절구모식、합리조절실온병유효보난、불상규방치복부인류관；술후연합진통、조기장내영양、진조발제복부인류관뇨관、조기공능단련화하상활동。결과：관찰조96례수술환자재병정지효솔、호리배합정도、만의도조사방면교대조조명현제고，술후항문배기배편시간교대조조제전，몰유출현악심구토、발열、오흡、폐부감염、정맥전새、절구감염등병발증，지유1례문합구루，대대축단료주원시간、강저료의료비용。결론：응용쾌통도외과기술대수술환자진행위수술기호리，능경합리유효지공제환자적병리생리변화，감소료궤체대수술소산생적응격화염증반응，명현감소료병발증，가쾌료술후강복적속도，감경료사회、의원급환자가정적경제부담，치득추엄。
Objective:To investigate the fast track surgery perioperative nursing application effect in operation period in general surgery.Method:192 patients were divided into two groups,96 operation patients of control group were treatedby by usual care;96 operation patients with fast track surgery of the observation group were treated by positive psychological nursing,detailed health education and effective communication before operation, appropriate to add the nutrition,not routine enema,not routine indwelling gastric tube catheter,fasting,shorten drinking time;transfusion volume and the amount of sufficient oxygen,water,preventive application of antibiotic selection,operation way better optimal anesthesia method and incision model,reasonable adjust the room temperature and effective heat,no routine abdominal drainage tube placed strict control of surgery;postoperative analgesia,early enteral nutrition,early removal of abdominal drainage catheter tube,early functional exercise and activities.Result:96 cases operation patients of the observation group in the disease awareness,nursing,degree of satisfaction survey was obviously improved,early postoperative anus exhaust defecation time,no nausea and vomiting,fever aspiration,lung infection,venous thrombosis,infection of incisional wound,only 1 case of anastomotic fistula,shorten the hospitalization time,reduced the cost of medical care.Conclusion:The application of fast track surgery for operation period nursing on patients with operation,can be more reasonable and effective control of pathological and physiological changes of patients,reduces stress and inflammatory response of operation,complications,accelerated postoperative recovery rate,the society,hospital and the patients economic burden of the family,which is worthy of promotion.