日间病房妇科腹腔镜手术患者快速康复循证护理实践

doi:10.16460/j.issn1008-9969.2019.15.031

摘要/Abstract

摘要： 目的构建并实施基于加速康复外科的日间妇科腹腔镜临床实践方案,并评价其效果。方法 A院区为观察组,组建跨学科团队,检索Up To Date临床决策系统、美国指南网、NICE、医脉通、The Cochrane Library、PubMed、CNKI、万方共8个数据库中加速康复的妇科腹腔镜临床实践指南、系统评价、证据总结,制定并实施基于加速康复外科的妇科腹腔镜日间临床实践方案。B院区为对照组,按妇科腹腔镜手术常规管理。对比2组患者非计划性二次手术及30 d再入院率,住院时间及住院费用。结果实施加速康复外科妇科腹腔镜手术的观察组平均住院时间、住院费用低于对照组,差异具有统计学意义（P<0.001）。2组非计划性二次手术均为0;2组30 d再入院率均在0.5%以内,差异无统计学意义（P>0.05）。结论基于加速康复外科的循证实践可优化妇科腹腔镜围手术期管理,实现日间妇科腹腔镜临床实践方案,促进患者康复、缩短住院时间,降低患者费用,保障患者安全。

关键词: 妇科腹腔镜, 加速康复外科, 临床实践, 住院时间

Abstract: Objective To construct and implement a clinical practice plan for daytime gynecological laparoscopic surgery based on accelerated rehabilitation surgery and evaluate its effect. Methods In observation group, an interdisciplinary team was established to retrieve clinical practice guidelines, systematic reviews, evidence summary, development and implementation of gynecological laparoscopic clinical practice based on accelerated rehabilitation in 8 databases including Up To Date Clinical Decision System, American Guide Network, NICE, Chinese Clinical Guide Library, The Cochrane Library, PubMed, CNKI, and Wanfang Data, then a gynecological laparoscopic clinical practice based on accelerated rehabilitation was developed and implemented. In control group, routine nursing of gynecological laparoscopic surgery was performed. Hospitalization time, medical cost, unplanned second surgery and 30-day readmission rate in the two groups were compared. Results Average hospitalization time and hospitalization cost in the observation group were shorter and lower than those in the control group (P<0.001). There was no unplanned second operation in both groups and the 30-day readmission rate in both groups was within 0.5%, which indicated no statistical significance (P>0.05). Conclusion Evidence-based nursing based on accelerated rehabilitation surgery can optimize perioperative management of gynecological laparoscopy. It promotes the rehabilitation of patients, shortens hospital stay, reduces medical costs, and ensures patient safety, which is worth of further promotion.

Key words: gynecological laparoscopy, accelerated rehabilitation surgery, clinical practice, hospitalization time

中图分类号:

R473.6

刘美玲, 龚桂芳, 肖玉梅, 范佳颖, 李煜, 春晓, 林艳. 日间病房妇科腹腔镜手术患者快速康复循证护理实践[J]. 护理学报, 2019, 26(15): 31-35.

LIU Mei-ling, GONG Gui-fang, XIAO Yu-mei, FAN Jia-ying, LI Yu, CHUN Xiao, LIN Yan. Evidence-based Nursing of Accelerated Rehabilitation for Patients Undergoing Gynecological Laparoscopic Surgery in Day-care Unit[J]. Journal of Nursing, 2019, 26(15): 31-35.

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