快速康复外科理念在自发性气胸患者围术期护理中的应用效果

摘要

目的 分析快速康复外科(FTS)理念在自发性气胸(SP)患者围术期护理中的应用效果.方法 选择2015年1月—2017年2月在咸宁市通城县人民医院行胸腔镜手术的SP患者120例,采用随机数字表法分为对照组和观察组,每组60例.两组患者均行胸腔镜手术,对照组患者给予常规围术期护理,观察组患者在FTS理念指导下进行围术期处理.比较两组围术期指标、术后并发症发生情况、手术前后肺功能指标、术后焦虑及抑郁程度.结果 观察组患者术后首次排气时间、胸腔引流管拔除时间、疼痛持续时间、呼吸机使用时间及住院时间短于对照组,镇痛药物使用次数少于对照组(P<0.05).观察组患者术后并发症发生率低于对照组(P<0.05).术前两组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分最大通气量(MMV)比较,差异无统计学意义(P>0.05);术后观察组患者FEV1、FVC、MMC高于对照组(P<0.05).观察组患者术后焦虑、抑郁程度轻于对照组(P<0.05).结论 在SP患者围术期护理中应用FTS理念可有效促进术后康复,减少术后并发症的发生,改善肺功能,缓解焦虑、抑郁情绪.%Objective To analyze the application effect of Fast Track Surgery(FTS) on perioperative nursing care for patients with spontaneous pneumothorax(SP).Methods From January 2015 to February 2017,a total of 120 patients SP undergoing thoracoscopic surgery were selected in the People's Hospital of Tongcheng County,Xianning,and they were randomly divided into control group and observation group,each of 60 cases. Patients in the two groups received thoracoscopic surgery,meanwhile patients in control group received routine perioperative nursing care,while patients in observation group received FTS guided perioperative nursing care. Perioperative indicators,incidence of postoperative complications,index of pulmonary function before and after surgery,severity anxiety and depression after surgery were compared between the two groups.Results First exhaust time after surgery,chest drainage tube removal time,duration of pain,using duration of breathing machine and hospital stays in observation group were statistically significantly shorter than those in control group, meanwhile number of using analgesics in observation group was statistically significantly less than that in control group(P<0.05). Incidence of postoperative complications in observation group was statistically significantly lower than that in control group (P<0.05). No statistically significant differences of FEV1,FVC or MMC was found between the two groups before surgery (P>0.05),while FEV1,FVC and MMC in observation group were statistically significantly higher than those in control group after surgery(P<0.05). Postoperative severity of anxiety and depression in observation group was statistically significantly milder than that in control group,respectively(P<0.05).Conclusion Application of FTS in perioperative nursing care can promote the postoperative recovery in patients with SP,reduce the risk of postoperative complications,improve the pulmonary function,relieve the severity of anxiety and depression.