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快速康复外科技术对腹腔镜胆囊切除术患者焦虑指数及应激指标的影响
Effect of fast track surgery on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy
文章发布日期:2017年01月06日  来源:  作者:芦霞,贾海明,米泰宇,等  点击次数:1261次  下载次数:226次

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【摘要】:目的观察快速康复外科(FTS)技术对腹腔镜胆囊切除术患者焦虑指数及应激指标的影响。方法选取2015年3月-2016年7月在兰州市第二人民医院普外科住院行腹腔镜胆囊切除术的患者400例,随机分为FTS组和传统治疗组,每组各200例。FTS组患者围手术期予以FTS技术处理,传统治疗组围手术期采用传统治疗理念处理。检测2组患者入院时、术前1 h及术后24 h、48 h的CRP、WBC、IL-6水平,以及汉密尔顿焦虑量表焦虑指数。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果入院时,FTS组与传统治疗组焦虑指数差异无统计学意义(P>0.05);术前1 h及术后24、48 h 2组患者的焦虑指数差异均有统计学意义(χ2值分别为12.73、13.17、14.12, P值均<0.05)。入院时和术前1 h,FTS组与传统治疗组患者CRP、WBC、IL-6水平差异均无统计学意义(P值均>0.05);术后24、48 h 2组患者的CRP、WBC、IL-6水平差异均有统计学意义[CRP24h:(8.47±0.78)mg/L vs (17.56±1.31) mg/L,WBC24h:(8.3±3.4)×109/L vs (10.2±3.8)×109/L,IL-624h:(127.43±37.46)ng/L vs (146.25±42.56) ng/L,t值分别为17.63、21.62、26.32,P值均<0.05;CRP48h:(6.57±1.27) mg/L vs (10.76±1.25) mg/L,WBC48h:(7.1±2.3)×109/L vs (9.3±2.4)×109/L,IL-648h:(103.27±38.54) ng/L vs (127.76±38.65) ng/L,t值分别为19.25、23.34、25.24,P值均<0.05]。FTS组和传统治疗组患者住院时间差异有统计学意义[(4±1) d vs (7±2) d,t=13.15,P<0.05];2组的住院费用差异也有统计学意义[(7800±500)元 vs (9200±600)元,t=10.61,P<0.05]。结论FTS技术有助于降低腹腔镜胆囊切除术后患者的焦虑情绪和应激反应,缩短住院时间,促进患者康复。
【Abstract】:ObjectiveTo investigate the effect of fast track surgery (FTS) on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy. MethodsThe patients who were hospitalized in Department of General Surgery, The Second People′s Hospital of Lanzhou, from March 2015 to July 2016 and underwent laparoscopic cholecystectomy were enrolled and randomly divided into FTS group and conventional treatment group, with 200 patients in each group. The patients in the FTS group were given FTS in the perioperative period, and those in the conventional treatment group were given conventional treatment. The C-reactive protein (CRP) level, white blood cell count (WBC), and interleukin-6 (IL-6) level were measured on admission, at 1 hour before surgery, and at 24 and 48 hours after surgery, as well as the anxiety index in Hamilton anxiety scale (HAMA). The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in anxiety index between the FTS group and the conventional treatment group on admission (P>0.05); at 1 hour before surgery and at 24 and 48 hours after surgery, there were significant differences in anxiety index between the two groups (χ2=12.73, 13.17, and 14.12, all P<0.05). On admission and at 1 hour before surgery, there were no significant differences in the CRP level, WBC, and IL-6 level between the FTS group and the conventional treatment group (all P>0.05); at 24 and 48 hours after surgery, there were significant differences in the CRP level, WBC, and IL-6 level between the two groups [CRP24h: 8.47±0.78 mg/L vs 17.56±1.31 mg/L, t=17.63, P<0.05; WBC24h: (8.3±3.4)×109/L vs (10.2±3.8)×109/L, t=21.62, P<0.05; IL-624h: 127.43±37.46 ng/L vs 146.25±42.56 ng/L, t=2632, P<0.05; CRP48h:(6.57±1.27) mg/L vs (10.76±1.25) mg/L,t=19.25,P<005;WBC48h:(7.1±2.3)×109/L vs (9.3±24)×109/L,t=23.34,P<005;IL-648h:(103.27±38.54) ng/L vs (127.76±38.65) ng/L,t=25.24,P<0.05]. There was a significant difference in the length of hospital stay between the FTS group and the conventional treatment group (4±1 d vs 7±2 d, t=13.15, P<0.05), and there was also a significant difference in hospital costs (7800±500 yuan vs 9200±600 yuan, t=10.61, P<0.05). ConclusionIn patients undergoing laparoscopic cholecystectomy, FTS helps to reduce anxious emotion and stress response, shorten the length of hospital stay, and promote their rehabilitation.
【关键字】:快速康复外科; 胆囊切除术, 腹腔镜; 手术期间; 应激
【Key words】:fast tract surgery; cholecystectomy, laparoscopic; intraoperative period; stress
【引证本文】:芦霞, 贾海明, 米泰宇,等. 快速康复外科技术对腹腔镜胆囊切除术患者焦虑指数及应激指标的影响[J]. 临床肝胆病杂志, 2017, 33(2): 308-312.

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