CAJ | 학술논문

目的：探讨快速康复外科（ FTS）理念对经肾上盏入路经皮肾镜取石术（ PCNL）围手术期护理的有效性。方法选择2011年11月-2013年12月在某院接受PCNL术的76例肾结石（ KS）患者，所有患者随机分为两组，每组各38例，干预组患者接受FTS模式护理干预，对照组接受常规护理。统计两组患者的住院时间、治疗费用、生活活动量表BI指数及患者并发症发生情况，并在护理结束后对患者进行护理满意度调查。结果干预组住院时间、治疗费用和BI指数得分分别为（8．8±2．3）d，（10980．6±966．3）元和（84．6±9．4）分，优于对照组的（12．4±3．0）d，（14315．3±1537．3）元和（68．9±7．3）分，差异有统计学意义（t值分别为4．682，9．473，6．741；P＜0．05）。干预组发生术后发热2例，术后疼痛2例，并发症发生率为10．5％；对照组严重出血4例，术后发热6例，术后疼痛2例，并发症发生率为31．6％，干预组优于对照组，差异有统计学意义（χ2＝5．067，P＜0．05）。干预组患者满意率为94．7％，高于对照组的78．9％，差异有统计学意义（χ2＝4．145，P＜0．05）。结论 KS患者经肾上盏入路PCNL围手术期采用FTS护理模式能有效减少并发症的发生，且得到患者认可，值得在临床上进一步推广。
목적：탐토쾌속강복외과（ FTS）이념대경신상잔입로경피신경취석술（ PCNL）위수술기호리적유효성。방법선택2011년11월-2013년12월재모원접수PCNL술적76례신결석（ KS）환자，소유환자수궤분위량조，매조각38례，간예조환자접수FTS모식호리간예，대조조접수상규호리。통계량조환자적주원시간、치료비용、생활활동량표BI지수급환자병발증발생정황，병재호리결속후대환자진행호리만의도조사。결과간예조주원시간、치료비용화BI지수득분분별위（8．8±2．3）d，（10980．6±966．3）원화（84．6±9．4）분，우우대조조적（12．4±3．0）d，（14315．3±1537．3）원화（68．9±7．3）분，차이유통계학의의（t치분별위4．682，9．473，6．741；P＜0．05）。간예조발생술후발열2례，술후동통2례，병발증발생솔위10．5％；대조조엄중출혈4례，술후발열6례，술후동통2례，병발증발생솔위31．6％，간예조우우대조조，차이유통계학의의（χ2＝5．067，P＜0．05）。간예조환자만의솔위94．7％，고우대조조적78．9％，차이유통계학의의（χ2＝4．145，P＜0．05）。결론 KS환자경신상잔입로PCNL위수술기채용FTS호리모식능유효감소병발증적발생，차득도환자인가，치득재림상상진일보추엄。
Objective To explore the effectiveness of fast-track surgery ( FTS) in perioperative nursing of patients with percutaneous nephrolithotomy lithotomy with upper-pole access (PCNL).Methods Seventy-six kidney stone ( KS) patients with PCNL in our hospital from November 2011 to December 2013 were chosen and randomly divided into the control group and the intervention group , each with 38 cases.The control group received the routine nursing , and the intervention group received the FTS nursing intervention .The hospital stays, the costs of treatment , the score of BI index of living scale and the incidence of complication were recorded and the patients ’ satisfaction were investigated at the end of nursing in two groups .Results The hospital stays, the costs of treatment, the score of BI index of living scale were respectively (8.8 ±2.3) d, (10 980.6 ±966.3)yuan and (84.6 ±9.4) in the intervention group, and were better than (12.4 ±3.0)d, (14 315.3 ±1 537.3) yuan and (68.9 ±7.3) in the control group, and the differences were statistically significant (t =4.682, 9.473, 6.741, respectively;P <0.05).The incidence rate of complication in the intervention group was 10.5% including 2 cases of postoperative fever and 2 cases of postoperative pain , and was better than 31.6% including 4 cases of severe bleeding , 6 cases of postoperative fever , and 2 cases of postoperative pain in the control group , and the difference was statistically significant (χ2 =5.067, P<0.05). The patients’ satisfaction was 94.7%in the intervention group, and was high than 78.9%in the control group, and the difference was statistically significant (χ2 =4.145,P<0.05).Conclusions FTS nursing intervention adopted in KS patients with PCNL during perioperative period can effectively reduce the incidence of complications , and be accepted by the patients , and which is worthy of further promotion in clinical practice .