目的：观察肝胆管结石肝切除术后双套管冲洗引流护理中实施综合护理干预措施的临床效果。方法对2012年6月到2014年6月烟台毓璜顶医院收治的70例肝胆管结石患者的临床资料进行回顾性分析，根据护理方式不同分为综合护理组（观察组）和常规护理组（对照组），每组35例。比较两组患者术中术后情况、临床疗效及并发症情况。结果观察组手术时间、术中出血量、术后下床活动时间、住院时间分别为（124.37±10.39）分钟、（56.57±10.43）ml、（1.93±0.64）天、（13.22±1.34）天；对照组手术时间、术中出血量、术后下床活动时间、住院时间分别为（144.76±11.55）分钟、（76.16±11.48）ml、（2.71±0.57）天、（17.36±2.27）天。两组患者术中术后情况比较，差异具有统计学意义（t=2.046、2.157、2.357、2.267，P=0.042、0.035、0.019、0.025）。观察组35例，痊愈29例（82.86%），好转6例（17.14%），愈合不好0例（0.00%），总有效率为100.00%；对照组35例，痊愈22例（62.86%），好转8例（22.85%），愈合不好5例（14.29%），总有效率为85.71%，两组临床疗效比较，差异具有统计学意义（χ2=5.026，P=0.021）。观察组切口感染1例（2.86%），并发症总发生率2.86%；对照组胆管感染1例（2.86%），胆漏1例（2.86%），出血2例（5.71%），切口感染4例（11.43%），并发症总发生率22.86%。两组并发症差异具有统计学意义（χ2=6.504，P =0.011）。结论综合护理干预在肝胆管结石肝切除术后双套管冲洗引流护理中可行，且具有较好的护理效果，能够减少手术创伤和术后并发症的发生，临床疗效更好。%Objective To observe the effect of comprehensive nursing intervention on double pipe irrigation drainage in hepatolithiasis hepatectomy. Methods Clinical data of 70 patients with hepatolith in Yantai Yuhuangding Hospital from June 2012 to June 2014 were retrospectively analyzed and divided into comprehensive nursing care group (observation group) and conventional nursing group (control group) according to different nursing methods, 35 cases in each group. The intraoperative situation, clinical efifcacy and postoperative complications of the two groups were compared. Results The operation time, intraoperative blood loss, postoperative bed activity time, and length of hospital stay were (124.37 ± 10.39) min, (56.57 ± 10.43) ml, (1.93 ± 0.64) d, (13.22 ± 1.34) d in the observation group and (144.76 ± 11.55) min, (76.16 ± 11.48) ml, (2.71 ± 0.57) d, (17.36 ± 2.27) d in the control group, respectively. The differences of postoperative situation in both groups were statistically signiifcant (t=2.046, 2.157, 2.357, 2.267;P=0.042, 0.035, 0.019, 0.025, respectively). In the observation group, 29 cases (82.86%) recovered, 6 cases (17.14%) improved and none was poor healing, the total effective rate was 100.00%. In the control group, 22 cases (62.86%) recovered, 8 cases (22.85%) improved and 5 cases (14.29%) were poor healing, the total effective rate was 85.71%. The difference of clinical curative effect between the two groups was statistically signiifcant (χ2=5.026, P=0.021). One case (2.86%) occured incision infection in the observation group, the incidence of complications was 2.86%. One case (2.86%) occured bile duct infection, 1 case (2.86%) occured bile leakage, 2 cases occured (5.71%) hemorrhage, and 4 cases (11.43%) were found infection of incision in the control group, the incidence of complications was 22.86%, the difference between the two groups was statistically signiifcant (χ2=6.504, P=0.011). Conclusions Comprehensive nursing intervention on hepatolith double pipe lfushing drainage after liver resection is feasible, and has a good nursing effect. It can reduce the surgical trauma and the postoperative complications, the clinical curative effect is better than conventional nursing.
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