腹腔镜下疝修补术联合预见性护理在老年腹股沟疝中的应用价值

doi:10.3877/cma.j.issn.1674-392X.2018.06.022

目的

探讨腹腔镜下疝修补术联合预见性护理在老年腹股沟疝中的应用价值。

方法

选取重庆市大足区人民医院普外科自2016年1月至2018年1月收治的150老年腹股沟疝患者为研究对象，依据随机数字表法分为试验组（75例）与对照组（75例）。2组均行腹腔镜下疝修补术治疗，对照组于围手术期给予常规护理，试验组在对照组的基础上给予预见性护理。比较2组手术前后慢性疼痛、术后并发症发生状况及平均住院时间。

结果

与术前相比，2组术后2周、1个月及2个月VRSs评分均下降（P<0.05），且试验组术后VRSs评分均显著低于对照组（P<0.05），差异具有统计学意义；术后试验组尿潴留、切口感染与肺部感染发生率显著低于对照组（P<0.05），试验组平均住院时间较对照组显著缩短（P<0.01），差异具有统计学意义。

结论

腹腔镜下疝修补围手术期应用预见性护理可有效促进老年腹股沟疝患者术后恢复，缩短住院时间，同时可降低并发症发生率，值得临床推广应用。

关键词: 疝，腹股沟, 疝修补术, 预见性护理, 老年

Objective

To explore the application value of laparoscopic herniorrhaphy combined with predictive nursing in elderly patients with inguinal hernia.

Methods

150 elderly patients with inguinal hernia in the Dazu District People's Hospital from January 2016 to January 2018 were selected as study subjects, they were divided into the experiment group (n=75) and the control group (n=75) according to the method of random number table. Laparoscopic herniorrhaphy were performed in 2 groups, routine nursing was given in the control group during perioperative period, and predictive nursing was given in the experiment group on the basis of the control group. The chronic pain before and after operation, the complications occurrence after operation and average hospital stay were compared between 2 groups.

Results

Compared with before operation, the VRSs scores of 2 groups at 2 weeks after operation, 1 month and 2 months after operation significantly decreased (P<0.01), and the VRSs score of the experiment group after operation was significantly lower than those of the control group (P<0.05). The incidences of urinary retention, incision infection and pulmonary infection in the experiment group were significantly lower than those in the control group (P<0.05); the average hospital stay in the experiment group was shorter than that in the control group (P<0.01).

Conclusion

Application of predictive nursing during perioperative period of laparoscopic herniorrhaphy can effectively promote the recovery of elderly patients with inguinal hernia and reduce the incidence of complications. It is worth popularizing and applying in clinic.

Key words: Hernia, inguinal, Herniorrhaphy, Predictive nursing, Elderly

表1 2组术后VRSs评分比较（分，±s）

组别	例数	术前	术后2周	术后1个月	术后2个月
对照组	75	2.30±0.34	2.12±0.29^a	1.81±0.32^a	1.63±0.05^a
试验组	75	2.35±0.37	1.98±0.30^ab	1.62±0.25^ab	0.85±0.06^ab

表1 2组术后VRSs评分比较（分，±s）

组别	例数	术前	术后2周	术后1个月	术后2个月
对照组	75	2.30±0.34	2.12±0.29^a	1.81±0.32^a	1.63±0.05^a
试验组	75	2.35±0.37	1.98±0.30^ab	1.62±0.25^ab	0.85±0.06^ab

表2 2组术中及术后并发症发生情况及住院时间比较[例（%）]

组别	例数	尿潴留	切口感染	肺部感染	平均住院时间(d, ±s)
对照组	75	7(9.33)	8(10.67)	9(12.00)	12.83±0.05
试验组	75	2(2.67)	2(2.67)^a	2(2.67)^a	8.45±0.06^a

表2 2组术中及术后并发症发生情况及住院时间比较[例（%）]

组别	例数	尿潴留	切口感染	肺部感染	平均住院时间(d, ±s)
对照组	75	7(9.33)	8(10.67)	9(12.00)	12.83±0.05
试验组	75	2(2.67)	2(2.67)^a	2(2.67)^a	8.45±0.06^a

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Application value of laparoscopic herniorrhaphy combined with predictive nursing in elderly patients with inguinal hernia

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Application value of laparoscopic herniorrhaphy combined with predictive nursing in elderly patients with inguinal hernia