CAJ | 학술논문

目的：探讨手术室护士实施综合性护理干预对腹腔镜胆总管切开探查取石术患者的心理状况及并发症的影响。方法全部入选病例均为本院2013年1月~2014年3月期间择期行腹腔镜胆总管切开探查取石术患者，根据护理方法不同分为干预组和对照组各40例，两组患者均由手术室护士进行围术期护理，其中对照组实施常规护理及随机对症护理，干预组手术室护士着重实施包括心理干预、T形管的护理、并发症的护理等综合性护理干预措施，比较两组患者术前和术后的焦虑心理状况SAS评分、两组患者的术中出血量、手术时间、术后排气时间、住院时间及两组患者的并发症情况。结果干预组和对照组的SAS评分术后与术前比较差异有统计学意义(P<0.05﹚，且干预组患者术后的SAS评分显著低于对照组(P<0.05﹚。干预组患者的术中出血量、术后排气时间与对照组比较，差异有统计学意义(P<0.05﹚，干预组患者的手术时间、住院时间略短于对照组，组间比较差异无统计学意义(P﹥0.05﹚。两组均未发生胆道狭窄，干预组患者术后发生胆石残留1例，术后出血1例，其并发症发生率达5.0%，显著低于对照组患者术后的并发症发生率27.5%(P<0.05﹚。其中干预组患者术后出血的发生率达2.5%，显著低于对照组的12.5%(P<0.05﹚。结论手术室护士对腹腔镜胆总管切开探查取石术患者通过实施综合性护理干预，有利于减轻患者的焦虑心理，减少并发症的发生率，从而明显提高手术治疗效果。
목적：탐토수술실호사실시종합성호리간예대복강경담총관절개탐사취석술환자적심리상황급병발증적영향。방법전부입선병례균위본원2013년1월~2014년3월기간택기행복강경담총관절개탐사취석술환자，근거호리방법불동분위간예조화대조조각40례，량조환자균유수술실호사진행위술기호리，기중대조조실시상규호리급수궤대증호리，간예조수술실호사착중실시포괄심리간예、T형관적호리、병발증적호리등종합성호리간예조시，비교량조환자술전화술후적초필심리상황SAS평분、량조환자적술중출혈량、수술시간、술후배기시간、주원시간급량조환자적병발증정황。결과간예조화대조조적SAS평분술후여술전비교차이유통계학의의(P<0.05﹚，차간예조환자술후적SAS평분현저저우대조조(P<0.05﹚。간예조환자적술중출혈량、술후배기시간여대조조비교，차이유통계학의의(P<0.05﹚，간예조환자적수술시간、주원시간략단우대조조，조간비교차이무통계학의의(P﹥0.05﹚。량조균미발생담도협착，간예조환자술후발생담석잔류1례，술후출혈1례，기병발증발생솔체5.0%，현저저우대조조환자술후적병발증발생솔27.5%(P<0.05﹚。기중간예조환자술후출혈적발생솔체2.5%，현저저우대조조적12.5%(P<0.05﹚。결론수술실호사대복강경담총관절개탐사취석술환자통과실시종합성호리간예，유리우감경환자적초필심리，감소병발증적발생솔，종이명현제고수술치료효과。
Objective To investigate the impact of nurses in operation room of implementing the comprehensive nursing intervention on psychological status and complications for laparoscopic common bile duct exploration patients. Methods All patients were selected in our hospital from January 2013 to March 2014 undergoing laparoscopic common bile duct exploration, according to different nursing methods they were randomly divided into intervention group and control group, 40 cases in each group. Two groups of patients were given perioperative nursing by nurses in operation room, the control group received the routine nursing and random symptomatic care, intervention group focused on the implemen-tation of comprehensive nursing intervention in nursing care such as psychological intervention, complications of T line pipe and complication care. The SAS score of two groups of patients before and after psychological intervention, opera-tion time, amount of bleeding complications, postoperative exhaust time, hospitalization time and rate of complication of two groups in surgery were compared. Results The postoperative SAS score of intervention group and the control group decreased significantly than preoperative (P<0.05). And the SAS score of the patients in the intervention group was significantly lower than that of the control group (P<0.05). The intraoperative bleeding volume, postoperative exhaust time of the intervention group were improved significantly compared with the control group (P<0.05), the operation time, hospitalization time of intervention group was shorter than that of the control group, but there were no significant dif-ference (P>0.05). The biliary stricture did not occur in two groups. In the intervention group, one case of gallstone residue, one case of postoperative. The complication rate in the intervention group was 5.0%,was significantly lower than the control group’s 12.5%(P<0.05). Conclusion Nursing in operation room to laparoscopic choledocholithotomy in patients through the implementation of comprehensive nursing intervention is beneficial to reduce the patients psycho-logical anxiety, reduce the incidence of complications and improve the operative effects.