摘要
目的分析加速康复外科对胆囊癌合并原发性高血压患者手术应激反应的影响。方法选取2019年1月至2022年1月期间新乡医学院第一附属医院收治的60例胆囊癌合并原发性高血压患者为研究对象,简单随机法分为对照组(n=30)和观察组(n=30),对照组围术期给予常规护理干预,观察组围术期给予加速康复外科干预,比较两组术后情况,组间比较采用t检验。结果观察组术后恢复通气、进食流质、排便、下床活动时间均短于对照组[(11.10±2.25)h比(19.85±2.64)h,(11.99±2.34)h比(22.45±3.65)h,(12.54±2.17)h比(31.55±14.27)h,(12.55±1.94)h比(19.86±2.26)h,t=2.481、2.147、2.917、2.678,P<0.05]。观察组术后4~48 h的VAS评分均低于对照组[(1.82±0.55)分比(2.26±0.37)分,(2.52±0.30)分比(3.44±0.45)分,(2.10±0.37)分比(2.48±0.45)分,(1.55±0.31)分比(1.89±0.39)分,(1.00±0.29)分比(1.54±0.34)分,t=2.001、2.559、2.495、2.858、2.253,P<0.05]。干预后观察组的各营养指标水平均高于对照组[(310.42±45.62)mg/L比(187.45±41.55)mg/L,(44.10±2.65)mg/L比(29.65±2.46)mg/L,(5.23±1.31)mmol/L比(3.12±1.45)mmol/L,(2588.45±49.95)μmol/L比(1993.77±51.26)μmol/L,t=2.559、2.013、2.823、2.537,P<0.05]。干预后观察组的各炎性反应指标水平均低于对照组[(10.54±1.81)pg/ml比(14.15±1.59)pg/ml,(11.54±1.88)pg/ml比(16.00±1.51)pg/ml,(14.54±1.99)mg/L比(19.10±2.06)mg/L,t=2.580、2.292、3.376,P<0.05]。拔管时观察组的各应激指标水平均低于对照组[(0.98±0.15)nmol/L比(1.13±0.08)nmol/L,(643.36±7.56)pmol/L比(663.85±8.54)pmol/L,(0.72±0.09)mmol/L比(0.85±0.10)mmol/L,(73.63±1.60)ng/L比(84.68±2.19)ng/L,(523.36±8.59)nmol/L比(554.45±9.12)nmol/L,t=2.561、2.456、2.125、2.580、2.412,P<0.05]。拔管时观察组的SBP、心率水平均低于对照组[(123.69±15.88)mmHg比(133.06±15.11)mmHg,(81.08±11.51)次/min比(94.06±12.17)次/min,t=2.511、2.253,P<0.05]。观察组术后并发症总发生率低于对照组(10.00%比36.67%,χ2=6.921,P<
Objective To analyze the effect of accelerated rehabilitation surgery on surgical stress response in patients with essential hypertension and gallbladder cancer.Methods A total of 60 patients with gallbladder cancer complicated with essential hypertension admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2019 to January 2022 were selected as the study subjects.It was divided into control group(n=30)and observation group(n=30)by simple random method.The control group was given routine nursing intervention in perioperative period,and the observation group was given accelerated rehabilitation surgical intervention in perioperative period.The postoperative conditions of the two groups were compared,and the comparison between groups was performed by t test.Results The time of recovery of ventilation,fluid intake,defecation and ambulation in the observation group was shorter than that in the control group[(11.10±2.25)h vs.(19.85±2.64)h,(11.99±2.34)h vs.(22.45±3.65)h,(12.54±2.17)h vs.(31.55±14.27)h,(12.55±1.94)h vs.(19.86±2.26)h,t=2.481,2.147,2.917,2.678,P<0.05].VAS score of the observation group was lower than that of the control group at 4-48 h after operation[(1.82±0.55)points vs.(2.26±0.37)points,(2.52±0.30)points vs.(3.44±0.45)points,(2.10±0.37)points vs.(2.48±0.45)points,(1.55±0.31)points vs.(1.89±0.39)points,(1.00±0.29)points vs.(1.54±0.34)points,t=2.001,2.559,2.495,2.858,2.253,P<0.05).After intervention,the levels of nutritional indexes in the observation group were higher than those in the control group[(310.42±45.62)mg/L vs.(187.45±41.55)mg/L,(44.10±2.65)mg/L vs.(29.65±2.46)mg/L,(5.23±1.31)mmol/L vs.(3.12±1.45)mmol/L,(2588.45±49.95)μmol/L vs.(1993.77±51.26)μmol/L,t=2.559,2.013,2.823,2.537,P<0.05].After intervention,the inflammatory response indexes in the observation group were lower than those in the control group[(10.54±1.81)pg/mL vs.(14.15±1.59)pg/ml,(11.54±1.88)pg/ml vs.(16.00±1.51)pg/ml,(14.54±1.99)mg/L vs.(19.10±2.06)mg/L,t=2.580,2.292,3.
作者
冯振
王建国
Feng Zhen;Wang Jianguo(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)
出处
《中华实验外科杂志》
CAS
北大核心
2022年第7期1355-1358,共4页
Chinese Journal of Experimental Surgery
关键词
胆囊癌
原发性高血压
加速康复外科
应激反应
Gallbladder cancer
Essential hypertension
Accelerated rehabilitation surgery
Stress response
