老年患者腹腔鏡膽囊切除術(shù)圍手術(shù)期護(hù)理

論文編號(hào):HL187  論文字?jǐn)?shù):12460.頁(yè)數(shù):28

論文題目：老年患者腹腔鏡膽囊切除術(shù)圍手術(shù)期護(hù)理
摘 要
研究目的
 探討圍手術(shù)期高質(zhì)量的綜合護(hù)理措施對(duì)患慢性結(jié)石性膽囊炎和膽囊息肉的老年LC圍手術(shù)期指標(biāo)及術(shù)后康復(fù)的影響。
研究方法
 以滁州市中西醫(yī)結(jié)合醫(yī)院外三科2009年11月1日到2011年5月1日期間住院的60歲以上的患慢性結(jié)石性膽囊炎和膽囊息肉的患者總計(jì)200例作為研究對(duì)象，隨即機(jī)分為兩組：治療組和對(duì)照組，其中治療組100例，采用規(guī)范系統(tǒng)的綜合護(hù)理方法進(jìn)行精心護(hù)理；對(duì)照組100例，給予外科一般常規(guī)護(hù)理。進(jìn)行以病人為中心的責(zé)任制護(hù)理模式和以工作為中心的功能制護(hù)理模式的比較，以圍手術(shù)期各相關(guān)指標(biāo)、并發(fā)癥出現(xiàn)例數(shù)以及病人滿(mǎn)意與否作為評(píng)價(jià)標(biāo)準(zhǔn)，探討規(guī)范系統(tǒng)的綜合護(hù)理方法對(duì)患者康復(fù)的影響。
研究結(jié)果
 200例中，195例手術(shù)成功，術(shù)后住院平均3～10天后痊愈出院。5例出現(xiàn)術(shù)后出血，治療組1例經(jīng)積極保守治療5～8天后痊愈出院，對(duì)照組4例手術(shù)再次止血后10日出院。術(shù)后并發(fā)膽漏1例，經(jīng)ERCP證實(shí)為毛細(xì)膽管損傷，積極保守治療和護(hù)理后于術(shù)后15天出院。二者比較具有統(tǒng)計(jì)學(xué)意義（p<0.05）。綜合護(hù)理促進(jìn)了患者術(shù)后功能恢復(fù)，提高了圍手術(shù)期各項(xiàng)指標(biāo)，縮短了患者住院天數(shù)。
結(jié)論
 通過(guò)術(shù)前的心理護(hù)理及認(rèn)真細(xì)致的宣教和術(shù)后積極的病情觀(guān)察、合理的飲食指導(dǎo)等，對(duì)促進(jìn)老年患者LC術(shù)后早日康復(fù)起到了十分重要的作用。
關(guān)鍵詞：老年患者，腹腔鏡膽囊切除術(shù)，圍手術(shù)期，綜合護(hù)理。
論文類(lèi)型：調(diào)查報(bào)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  錄
 中文摘要 V
英文摘要 VI
1 緒論 1
 1.1研究背景及意義 1
 1.2研究目的及目標(biāo) 2
 1.3關(guān)鍵詞及定義 2
 1.4文獻(xiàn)回顧 3
2對(duì)象與方法 7
 2.1研究設(shè)計(jì) 7
 2.2研究對(duì)象 7
 2.3研究方法 7
 2.4研究步驟 7
 2.5研究工具 8
3研究結(jié)果 9
 3.1一般資料 9
 3.2兩組患者圍手術(shù)期指標(biāo)比較 9
 3.3兩組患者并發(fā)癥出現(xiàn)例數(shù)比較 10
 3.4兩組患者滿(mǎn)意程度比較 10
4討論 11
 4.1綜合護(hù)理提高了圍手術(shù)期各項(xiàng)指標(biāo) 11
 4.2綜合護(hù)理對(duì)患者術(shù)后胃腸功能恢復(fù)的影響 11
 4.3綜合護(hù)理對(duì)患者自護(hù)能力的影響 12
 4.4綜合護(hù)理對(duì)患者術(shù)后住院天數(shù)及滿(mǎn)意度的影響 12
5推論及建議 13
 5.1推論 13
 5.2建議 13
致    謝 15
參考文獻(xiàn) 17
附錄 18