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手術(shù)時(shí)間對(duì)全麻腹部術(shù)后康復(fù)的影響和護(hù)理對(duì)策
摘要：通過(guò)將70例全麻腹部手術(shù)患者按手術(shù)時(shí)間長(zhǎng)短分成二組，對(duì)術(shù)后各項(xiàng)康復(fù)指標(biāo)進(jìn)行細(xì)化觀察和對(duì)照，明確了長(zhǎng)時(shí)間手術(shù)對(duì)術(shù)后的呼吸、消化、生理反應(yīng)以及自主活動(dòng)（功能）恢復(fù)等方面所產(chǎn)生的不良影響。由此，在加速麻醉藥物的排泄、改善呼吸功能、促進(jìn)胃腸功能、加強(qiáng)舒適護(hù)理方面積極采取了一系例對(duì)應(yīng)措施，全面提高了全麻腹部手術(shù)患者的康復(fù)質(zhì)量。關(guān)鍵詞： 手術(shù)時(shí)間 全麻 腹部手術(shù) 康復(fù) 影響 護(hù)理
Effect of the Duration of Operation on Recovery after Various Abdominal Operations under General Anesthesia and it’s Nursing StrategyZHENG Wen-ya，WANG Jian，YAO Man-lingAbstract：Seventy consecutive cases undergoing abdominal operation under general anesthesia were classified into two groups in accordance with the duration of operation. Through analysis of some post-operative recovery index ，it is discovered that long-duration has negative effect on respiration,digestion,physiological response and recovery of function after operation. The quality of recovery of those patients undergoing abdominal operation can be improved by accelerating discharge of anesthetic drugs，improving respiration，exciting gastro-intestinal function and emphasizing comfort nursing.
Key word:Duration of operation,Gerneral anesthesia, Abdominal operation,Post-operative recovery,Effect,Nursing
手術(shù)時(shí)間作為一個(gè)影響全麻術(shù)后康復(fù)的重要因素，早已引起大家的重視。隨著現(xiàn)代外科醫(yī)學(xué)的發(fā)展，施行外科手術(shù)的時(shí)間較以前有所縮短，但在現(xiàn)有的條件下，手術(shù)時(shí)間仍是困擾目前全麻術(shù)后康復(fù)的主要因素之一。本課題從70例全麻腹部手術(shù)病人入手，通過(guò)對(duì)不同手術(shù)時(shí)間患者的術(shù)后各項(xiàng)康復(fù)指標(biāo)的觀察和對(duì)照，明確了長(zhǎng)時(shí)間手術(shù)對(duì)術(shù)后 康復(fù)所造成的不良方面，由此，我們主動(dòng)地采取了一系例對(duì)應(yīng)措施，在提高全麻腹部手術(shù)患者的康復(fù)質(zhì)量方面取得了明顯的效果。下面就將我們的研究報(bào)告如下。
1.資料和方法
1. 1 臨床資料 全麻腹部手術(shù)患者共70例，男性31例，女性39例，術(shù)前均無(wú)嚴(yán)重的心、肺等疾病，按照手術(shù)時(shí)間長(zhǎng)短分為二組，每組35例。第一組手術(shù)時(shí)間≤2小時(shí)，年齡為32-75歲，平均年齡為57歲，手術(shù)方式為膽道手術(shù)15例，結(jié)直腸手術(shù)8例，胃切除5例，腸粘連分解術(shù)3例，腸套疊松解術(shù)2例，脾切除術(shù)2例。第二組手術(shù)時(shí)間〉2小時(shí)，年齡37-75歲，平均年齡為61歲，手術(shù)方式為膽道手術(shù)13例，結(jié)直腸手術(shù)10例，胃切除8例，胰臟手術(shù)2例，門(mén)高壓手術(shù)2例。
1． 2方法 對(duì)二組手術(shù)患者在術(shù)后第一天進(jìn)行觀察和記錄，觀察內(nèi)容包括咳嗽、咳痰、氣
促、胸悶、惡心、嘔吐、、腹脹、呃逆、咽喉疼痛、腰背酸疼，根據(jù)癥狀自評(píng)量表[1]（見(jiàn)表1）進(jìn)行打分。并在術(shù)后幾天跟蹤觀察自主活動(dòng)（功能）恢復(fù)的時(shí)間，包括翻身、起床、腸蠕動(dòng)、進(jìn)食情況，依次根據(jù)恢復(fù)時(shí)間段制定五
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