关键词: 加速康复外科, 围手术期, 胆囊结石, 胆总管结石, 腹腔镜胆总管切开取石术, 一期缝合

Abstract:

Objective To explore the application effect of enhanced recovery after surgery(ERAS) concept in the perioperative nursing of laparoscopic choledocholithotomy and primary suture. Method The clinical data of 60 patients with common bile duct stones and gallbladder stones admitted to Kunshan Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from October 2019 to June 2023 were retrospectively analyzed. According to different nursing concepts, they are divided into an accelerated rehabilitation group (ERAS group) and a traditional nursing method group (control group), with 30 cases in each group. The control group was in accordance with the perioperative routine nursing plan, while the ERAS group was combined with psychological intervention, perioperative nutritional supporting, and traditional Chinese medicine therapy based on routine nursing. The operation-related indexes and postoperative complications of the two groups were observed and compared. Result The postoperative anal exhaust time, defecation time, postoperative abdominal drainage time and hospital stay in ERAS group were significantly shorter than those in control group (P ＜ 0.05). The postoperative incision pain score was lower in the ERAS group (P ＜ 0.05). The incidence of postoperative complications in the ERAS group was 10.0% (3/30), which was slightly lower than 16.7% (5/30) in the control group, there was no difference between two groups(P ＞ 0.05). Conclusion The application of ERAS concept nursing in the perioperative period of laparoscopic common bile duct lithotomy and primary suture is effective and safe, which can accelerate the recovery of postoperative gastrointestinal function, reduce the time of drainage tube indwelling and shorten the length of hospital stay.

Key words: Enhanced recovery after surgery, Perioperative nursing, Cholecystolithiasis, Choledocholithiasis, Laparoscopic choledocholithotomy, Primary suture