基于ERAS理念的围手术期护理对胆囊结石伴急性胆囊炎患者康复、炎症和应激的影响

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国家科技期刊平台
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中文摘要：目的:探讨基于加速康复外科(enhanced recovery after surgery，ERAS)理念的围手术期护理对胆囊结石伴急性胆囊炎患者康复、炎症和应激的影响。方法:选取 2022 年 1 月—2023 年 7 月和县人民医院收治的 82 例胆囊结石伴急性胆囊炎患者作为研究对象，采用随机数表法将患者分为对照组和ERAS组，各 41 例。两组均行腹腔镜胆囊切除术(laparoscopic cholecystectomy，LC)，对照组给予传统围手术期护理，ERAS组给予基于ERAS理念的围手术期护理。比较两组康复效果、炎症指标[白细胞介素-6(interleukin-6，IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)和白细胞介素-1β(interleukin-1β，IL-1β)]、应激指标[皮质醇(cortisol，COR)、肾上腺素(epinephrine，EPI)和去甲肾上腺素(norepinephrine，NE)]及术后并发症。结果:ERAS组首次排气时间、胃肠功能恢复时间和住院时间短于对照组，下床活动时间长于对照组，差异有统计学意义(P<0。05);ERAS组术后3 d血清IL-6、TNF-α、IL-1β、COR、EPI和NE水平低于对照组，差异有统计学意义(P<0。05);随访6个月，ERAS组术后并发症总发生率低于对照组，差异有统计学意义(P<0。05)。结论:基于ERAS理念的围手术期护理能有效促进胆囊结石伴急性胆囊炎患者的康复，减少炎症和应激反应，降低并发症发生率。

外文标题：Effect of Perioperative Nursing Based on ERAS Concept on Rehabilitation,Inflammation and Stress in Patients with Cholecystolithiasis and Acute Cholecystitis

外文摘要：Objective:To explore the effect of perioperative nursing based on enhanced recovery after surgery(ERAS)concept on recovery,inflammation and stress in patients with cholecystolithiasis and acute cholecystitis.Method:A total of 82 patients with cholecystolithiasis and acute cholecystitis who admitted to He County People's Hospital from January 2022 to July 2023 were selected as the research objects,the patients were divided into the control group and the ERAS group by random number table method,with 41 cases in each group.Two groups were underwent laparoscopic cholecystectomy(LC),the control group was given traditional perioperative nursing,and the ERAS group was given perioperative nursing based on ERAS concept.The rehabilitation effect,inflammatory indexes[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)],stress indexes[cortisol(COR),epinephrine(EPI)and norepinephrine(NE)]and postoperative complications were compared between two groups.Result:The first exhaust time,gastrointestinal function recovery time and hospitalization time in the ERAS group were shorter than those in the control group,and the time of getting out of bed was longer than that in the control group,the differences were statistically significant(P<0.05).The levels of serum IL-6,TNF-α,IL-1β,COR,EPI and NE in the ERAS group at 3 d after operation were lower than those in the control group,and the differences were statistically significant(P<0.05).After 6 months of follow-up,the total incidence of postoperative complications in the ERAS group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Perioperative nursing based on ERAS concept can effectively promote recovery in patients with cholecystolithiasis and acute cholecystitis,reduce inflammation and stress responses,and lower the incidence of complications.

外文关键词：

Enhanced recovery after surgeryCholecystolithiasisAcute cholecystitisRecoveryInflammationStress

作者：

杨尚柱、童媛媛

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作者单位：

和县人民医院安徽和县 238200

关键词：

加速康复外科胆囊结石急性胆囊炎康复炎症应激

出版年：

2024

DOI：