Effect of fast track surgery-clinical nursing pathways on postoperative rehabilitation of patients with complex intrahepatic bile duct stones
Objective lo investigate the effect of fast track surgery-clinical nursing pathways(FTS-CNP)on the rehabilita-tion of patients with complex intrahepatic bile duct stones(CIHBDS)undergoing laparoscopic cholangiolithotomy.Meth-ods A total of 92 CIHBDS patients admitted to Nanyang First People's Hospital from May 1,2021 to May 31,2022 were selected and divided into routine group(46 cases)and FTS-CNP group(46 cases)by random number table method.Laparoscopic cholangiolithotomy was performed in both groups,and conventional group received routine perioperative clinical route nursing intervention.FTS-CNP group received FTS-CNP nursing intervention.The recovery process,post-operative pain degree[visual analogue scale(VAS)score],complication occurrence,psychological state[Hamilton anxie-ty scale(HAMA)and Hamilton depression scale(HAMD)score]and nursing satisfaction were compared between the two groups.Results The first exhaust time in the FTS-CNP group was(6.20±1.04)h,which was shorter than that in the conventional group(11.92±1.89)h;the first eating time was(6.87±1.05)h,shorter than that in the conventional group(12.35±2.78)h;the first ambulation time was(5.21±0.93)h,shorter than that in the conventional group(10.95±1.71)h;and the hospital stay was(6.89±1.32)d,shorter than that in the conventional group(9.26±2.10)d.The differences were statistically significant,with t-values of 17.984,12.507,20.000,and 6.344,respectively,all P＜0.001.After3 days of operation,the pain degree of FTS-CNP group was significantly less than that of conventional group(Z=4.309,P＜0.001).The complication rate of FTS-CNP group(4.35％)was lower than that of conventional group(21.74％),x2=6.133,P=0.013.After nursing,the HAMA and HAMD scores in the FTS-CNP group were(8.11±2.49)points and(9.74±2.57)points,respectively,which were significantly lower than those in the convention-al group(10.78±2.71)points and(11.22±2.81)points,and the differences were statistically significant(F values were 17.330 and 3.895,P values were＜0.001 and 0.024).The satisfaction of nursing work in FTS-CNP group(93.48％)was higher than that in conventional group(76.09％),x2=5.392,P=0.020.Conclusion FTS-CNP nursing intervention can accelerate the rehabilitation process of CIHBDS patients undergoing laparoscopic cholangiolithotomy,re-duce the degree of postoperative pain,adjust negative psychological state,reduce the occurrence of complications and im-prove nursing satisfaction.
complex intrahepatic bile duct stonesfast track surgery conceptclinical pathway nursinglaparoscopic cholangiolithotomyrehabilitation process
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