基因组学与应用生物学

为探讨快速康复外科在妇科腹腔镜手术围手术期的应用效果,本研究对2015年5月至2017年6月在本院应用腹腔镜手术治疗的122例患者随机分组,对照组患者应用常规护理,试验组患者实施快速康复外科,观察比较两组患者非切口疼痛持续时间、各时间点视觉模拟评分(visual analogue scale, VAS)、术后恶心呕吐发生率、术后恶心程度视觉模拟评分(visual analogue scale of nausea, NVAS)、胃复安使用率、围手术情况差异。结果表明,试验组患者2 h疼痛比例1.64%、6 h疼痛比例8.20%、24 h疼痛比例3.28%、48 h疼痛比例0.00明显低于对照组(p<0.05);试验组患者手术结束时VAS评分(3.87±1.05)分、术后2 h (3.61±0.87)分、术后6 h (2.34±0.56)分、术后24 h (2.17±0.34)分、术后48 h (0.23±0.09)分明显低于对照组(p<0.05);试验组患者恶心呕吐发生率6.56%、术后NVAS评分(1.21±0.68)分和胃复安使用率4.92%,差异具有统计学意义(p<0.05);试验组患者引流管拔除时间(2.51±0.96) d、术后排气时间(1.42±0.53) d、住院时间(8.51±2.49) d同对照组比较明显下降(p<0.05)。本研究初步表明,针对妇科腹腔镜患者应用快速康复外科可缓解疼痛,降低术后恶心呕吐发生率,提高治疗效果,促进患者康复,值得推广应用。

In order to explore the application effect of rapid rehabilitation surgery in the perioperative period of gynecologic laparoscopic surgery, this study divided 122 patients who underwent gynecological laparoscopic surgery in our hospital from May 2015 to June 2017 into two groups randomly. Patients in the control group were treated with routine nursing and patients in the experimental group underwent rapid rehabilitation surgery. The duration of non-incision pain, visual analogue scale(VAS) in different time points, incidence of postoperative nausea and vomiting, postoperative visual analogue scale of nausea(NVAS), utilization rate of metoclopramide,and perioperative differences were observed and compared between the two groups. The results showed that in the experimental group, the patients' 2 h pain rate was 1.64%, the 6 h pain rate was 8.20%, the 24 h pain rate was3.28%, and the 48 h pain rate was 0.00, which was significantly lower than that in the control group(p<00.05). At the end of the operation, patients in the experimental group received VAS score(3.87±1.05), the VAS score was(3.61±0.87),(2.34±0.56),(2.17±0.34), and(0.23±0.09) at the 2 h, 6 h, 24 h, and 48 h post-operation, which was significantly lower than that in the control group(p<00.05). The incidence of nausea and vomiting was 6.56%, the postoperative NVAS score was(1.21 ±0.68), and the metoclopramide u se rate was 4.92% in the experimental group, the difference was statistically significant(p<0.05). In the experimental group, the drainage tube removal time was(2.51±0.96) d, the postoperative exhaust time was(1.42±0.53) d, and the hospitalization time was(8.51±2.49) d, which decreased significantly compared with the control group(p<0.05). This study initially showed that the application of rapid rehabilitation surgery for gynecological laparoscopic patients could relieve pain, reduce the incidence of postoperative nausea and vomiting, improve the treatment effect, and promote the rehabilitation of patients, which might be worthy of popularization and application.