Clinical effects of perioperative fast track nursing of laparoscopic splenectomy and azygoportal disconnection

Abstract

Objective To explore clinical effects and key points of perioperative fast track nursing of laparoscopic splenectomy and azygoportal disconnection. Methods A total of 62 cirrhotic patients with portal hypertension, who received improved laparoscopic splenectomy and pericardial devascularization between January and November 2016 in Clinical Medical College of Yangzhou University, were retrospectively reviewed and analyzed for clinical data. Patients in the observation group (n=32) were managed with perioperative fast track nursing with canceled nasogastric intubation, being given diet management, keeping warm during perioperative period, continuing low flow rate of oxygen inhalation, early activity, and restriction and balance of perioperative fluid infusion. Patients in the control group (n=30) just received routine perioperative nursing. The clinical effects of two groups were compared. Results Laparoscopic splenectomy and azygoportal disconnection were successful in all patients. There were no significant differences between the observation and control groups in operation time[ (165.6±12.3) min vs. (163.5±12.5) min]and blood loss[ (109.4±64.8) ml vs. (103.7±51.2) ml] (t=0.675, 0.383; P>0.05) . First oral intake time after operation was (1.1±0.3) d, postoperative off-bed activity time (1.2±0.4) d, initial passage of flatus time (2.4±0.8) d, postoperative fever (3.5±2.2) d and postoperative hospital stay (9.0±1.6) d in the observation group were all less than those in the control group [ (1.9±0.6) , (2.6±0.7) , (3.0±0.9) , (4.8±2.2) , (10.4±2.2) d) ] (t=-6.560, -9.795, -2.478, -2.371, -2.893; P<0.05) . Conclusions Perioperative fast track nursing of laparoscopic splenectomy and azygoportal disconnection will guarantee fast postoperative recovery. Key words: Laparoscopy; Cirrhosis; Hypertension, portal vein; Perioperative nursing