Abstract
Objective To explore the clinical effect of rapid rehabilitation in the perioperative nursing of patients who received total laparoscopic hiatal hernia repair and analyze specific methods and practice. Methods Totally 236 patients who received total laparoscopic hiatal hernia repair between June 2012 and June 2016 were selected by purposive sampling method and were divided into the control group and the intervention group by using the random function method, with 118 patients in each group. Patients in the control group received routine nursing, while patients in the intervention group received nursing based on the concept of rapid rehabilitation, namely, health education related to diseases and operations before operation, reduction of in-dwelling urethral catheter, temperature and humidity control, infusion warming, warmth retention of human body and infusion volume control during operation as well as early ambulation, early removing of stomach tubes, preventive use of thrombus therapeutic instrument and other nursing measures for rapid rehabilitation after operation. The differences in time of early ambulation, time of anal exhaust, time of first feeding, postoperative morbidity, hospitalization time and hospitalization expenses between two groups were compared. Results The proportion of ambulation within 24 hours after surgery in the intervention group was 93.22%, which was higher than that in the control group (40.68%) (χ2=73.611, P<0.01) ; the time of removing stomach tubes, anal exhaust and first feeding were [ (19.5±4.70) , (21.9±2.2) , (23.6±3.1) ] hours in the intervention group, and they were shorter than those in the control group [ (26.8±3.6) , (26.5±1.8) , (28.9±4.3) ] hours (t=13.394, 17.579, 10.861; P<0.01) ; the incidence rate of postoperative complications in the intervention group was 2.54%, which was lower than that in the control group (18.64%) (χ2=16.151, P<0.05) ; in the intervention group, the postoperative hospitalization time and expenses were (5.6±2.1) days and (28 772.9±1890.1) yuan, and they were lower than those in the control group [ (7.8±1.8) days, (30 011.7±2113.4) yuan] (t=8.640, 4.746; P<0.01) . Conclusions The application of rapid rehabilitation in the perioperative nursing of patients with hiatal hernia repair enables patients to ambulate earlier, reduce the incidence of postoperative complications and accelerate the recovery of intestinal functions after operation. Key words: Perioperative nursing; Laparoscope; Hernia, esophageal hiatus; Rapid rehabilitation nursing
Published Version
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