老年患者腹腔镜胆囊切除术围手术期护理

论文编号:HL187  论文字数:12460.页数:28

论文题目：老年患者腹腔镜胆囊切除术围手术期护理
摘 要
研究目的
 探讨围手术期高质量的综合护理措施对患慢性结石性胆囊炎和胆囊息肉的老年LC围手术期指标及术后康复的影响。
研究方法
 以滁州市中西医结合医院外三科2009年11月1日到2011年5月1日期间住院的60岁以上的患慢性结石性胆囊炎和胆囊息肉的患者总计200例作为研究对象，随即机分为两组：治疗组和对照组，其中治疗组100例，采用规范系统的综合护理方法进行精心护理；对照组100例，给予外科一般常规护理。进行以病人为中心的责任制护理模式和以工作为中心的功能制护理模式的比较，以围手术期各相关指标、并发症出现例数以及病人满意与否作为评价标准，探讨规范系统的综合护理方法对患者康复的影响。
研究结果
 200例中，195例手术成功，术后住院平均3～10天后痊愈出院。5例出现术后出血，治疗组1例经积极保守治疗5～8天后痊愈出院，对照组4例手术再次止血后10日出院。术后并发胆漏1例，经ERCP证实为毛细胆管损伤，积极保守治疗和护理后于术后15天出院。二者比较具有统计学意义（p<0.05）。综合护理促进了患者术后功能恢复，提高了围手术期各项指标，缩短了患者住院天数。
结论
 通过术前的心理护理及认真细致的宣教和术后积极的病情观察、合理的饮食指导等，对促进老年患者LC术后早日康复起到了十分重要的作用。
关键词：老年患者，腹腔镜胆囊切除术，围手术期，综合护理。
论文类型：调查报告。
 Paper topic: The old age patient peritoneoscope gallbladder excision method encircles surgery time nursing
ABSTRACT
Objectives:
 The influence which after the trouble chronic stone cholecystitus and gallbladder polyp''''s old age LC the discussion encircles the surgery time high grade synthesis nursing measure encircles surgery time target and technique is restored to health.
Methods:
 By Chuzhou Cooperation of Chinese and Western medicine Hospital outside three branches on November 1st, 2009 to May 1, 2011 the period in hospital''''s 60 year-old above trouble chronic stone cholecystitus and the gallbladder polyp''''s patient amounts to 200 examples to take the object of study, the fuselage is immediately two groups: Treatment group and control group, treats the group 100 examples, uses the standard system''''s synthesis nursing method to carry on careful nursing; The control group 100 examples, give surgical department general convention nursing. Carries on and take works take the patient as the central responsibility system nursing pattern as the central function system nursing pattern comparison, encircles surgery time each index of correlation, the complication to present the example number as well as the patient satisfies or not takes the evaluation criteria, the discussion standard system''''s synthesis nursing method the influence which is restored to health to the patient.
Results:
 In 200 examples, 195 example surgeries are successful, after the technique, is hospitalized average for 3~10 days later is discharged. after 5 examples present the technique bleeds, the treatment group 1 example positive treats 5~8 days later conservatively is discharged, the control group 4 example surgeries stop bleeding latter on 10th to leave the hospital once more. After the technique, concurrent cholerrhagia 1 example, after the ERCP confirmation for bile capillary damage, after positive conservative treatment and nursing, in technique latter 15 day of being out of hospital. The treatment group complication has the example several 1 example, the control group is 4 examples.The two comparison has statistics significance(p<0.05).
Conclusion:
 After technique psychological nursing and earnest careful propaganda and technique the positive condition observation, the reasonable diet instruction and so on, after promoting the old age patient LC technique soon will be restored to health the very vital role.
 Key word: The old age patient, the peritoneoscope gallbladder excision method, encircles the surgery time, synthesis nursing.
Paper type: Report research.
 
 
目  录
 中文摘要 V
英文摘要 VI
1 绪论 1
 1.1研究背景及意义 1
 1.2研究目的及目标 2
 1.3关键词及定义 2
 1.4文献回顾 3
2对象与方法 7
 2.1研究设计 7
 2.2研究对象 7
 2.3研究方法 7
 2.4研究步骤 7
 2.5研究工具 8
3研究结果 9
 3.1一般资料 9
 3.2两组患者围手术期指标比较 9
 3.3两组患者并发症出现例数比较 10
 3.4两组患者满意程度比较 10
4讨论 11
 4.1综合护理提高了围手术期各项指标 11
 4.2综合护理对患者术后胃肠功能恢复的影响 11
 4.3综合护理对患者自护能力的影响 12
 4.4综合护理对患者术后住院天数及满意度的影响 12
5推论及建议 13
 5.1推论 13
 5.2建议 13
致    谢 15
参考文献 17
附录 18