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| Application of fast track surgery concept combined with clinical nursing pathway in patients undergoing laparoscopic cholecystectomy |
| BAO Haiyan1 ZHANG Ting2 ZHAO Kang1 |
1.Hospital of Ningshan County, Shaanxi Province, Ningshan 711600, China;
2.Center Hospital of Ankang City, Shaanxi Province, Ankang 725000, China |
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Abstract Objective To explore the application of fast track surgery (FTS) concept combined with clinical nursing pathway in patients undergoing laparoscopic cholecystectomy (LC). Methods From June 2015 to June 2017, in Hospital of Ningshan County, 108 patients with gallbladder disease treated with LC were selected, according to different nursing methods, they were divided into two groups, with 54 cases in each group. The convention group was given perioperative standardized clinical nursing pathway intervention, while FTS group was given perioperative FTS combined with clinical nursing pathway intervention. Preoperative negative emotions, postoperative pain, sleep quality and recovery in the two groups were observed, levels of inflammatory stress and blood glucose, postoperative complications and nursing satisfaction in two groups were compared. Results The positive and negative affect schedule (PANAS) score in FTS group at 1 d before operation, visual analogue scale (VAS) and electronic Pittsburgh sleep quality index (ePSQI) scores in FTS group at 1 d after operation were significantly lower than convention group, the differences were statistically significant (P < 0.05). The postoperative initial anal exhaust time, recovery time of bowel sound, the time of taking food for the first time, initial ambulation time and hospitalization time in FTS group were significantly shorter than convention group, the differences were statistically significant (P < 0.05). The white blood cell count (WBC), percentage of neutrophils (GRA), C reactive protein (CRP) and blood glucose levels in the two groups at 1, 3 d after operation were significantly higher than 1 d before operation, and 1 d after operation was significantly greater than 3 d after operation, the improvement of above-mentioned indexes in FTS group at different time points after operation were greater than convention group, the differences were statistically significant (P < 0.05). The incidence rates of complications in FTS group was lower than convention group, the difference was statistically significant (P < 0.05). The nursing satisfaction in FTS group was higher than convention group, the difference was statistically significant (P < 0.05). Conclusion The application of FTS concept combined with clinical nursing pathway in the perioperative nursing for patients undergoing LC can effectively relieve the psychological and physiological stress response, promote the postoperative revcovery and reduce complications, the nursing satisfaction of patients is high.
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