自制便携式防漏引流袋在腹腔镜脾切除联合贲门周围血管离断术后腹水外漏患者中的应用效果评价

Application effect of self-made leak-proof drainage bag in treating perioperative ascites leakage of patients with laparoscopic splenectomy and pericardial devascularization

  • 摘要:
    目的 观察自制便携式防漏引流袋在腹腔镜脾切除联合贲门周围血管离断术后腹水外漏患者中的应用效果。
    方法 选取2016年1月-2022年8月扬州大学临床医学院收治的67例腹腔镜脾切除联合贲门周围血管离断术后腹水外漏患者为研究对象, 其中2019年5月及以前采用传统换药方法处理的33例患者设为对照组, 2019年6月及以后采用自制的引流袋处理的34例患者设为观察组。比较2组患者相关手术指标。
    结果 所有患者均顺利完成手术。观察组手术时间为(164.7±21.2) min, 术中失血量为(83.2±78.8) mL, 与对照组的(159.1±19.8) min、(92.1±82.7) mL比较, 差异无统计学意义(P>0.05)。观察组术后首次下床活动时间、每周下床活动时间、术后肛门排气时间、术后住院时间依次为(2.6±0.8)、(5.3±0.8)、(2.7±0.7)、(10.3±1.7) d, 均优于对照组的(3.3±0.6)、(3.3±1.2)、(3.5±1.1)、(12.4±1.0) d, 差异均有统计学意义(P < 0.05)。观察组每周护理被呼叫频次、每周换药频次、每周换药费用、患者抱怨率依次为(2.5±1.1)次、(2.4±0.6)次、(60.7±7.3)元人民币、2.94%(1/34), 均低于对照组的(14.8±2.8)次、(11.4±2.0)次、(147.7±26.2)元人民币、75.76%(25/33), 差异均有统计学意义(P < 0.05)。
    结论 自制的便携式防漏引流袋用于防治腹腔镜脾切除联合贲门周围血管离断术后腹水外漏的效果显著, 不但降低了护理人员和临床医生的工作量, 还提高了术后护理的依从性, 促进了术后的快速康复, 提高了满意度。

     

    Abstract:
    Objective  To observe the application effect of self-made leak-proof drainage bag in treating perioperative ascites leakage of patients with laparoscopic splenectomy and pericardial devascularization.
    Methods  A total of 67 patients with ascites leakage after laparoscopic splenectomy and pericardial devascularization from January 2016 to August 2022 in the Clinical Medical College of Yangzhou University were selected as research objects. Among them, 33 patients treated with traditional dressing change methods in May 2019 and before were assigned to control group, and 34 patients treated with self-made drainage bag in June 2019 and thereafter were assigned to observation group. The relevant surgical indicators were compared between two groups.
    Results  All the patients successfully completed the surgeries. The operation time and the intraoperative blood loss in the observation group were (164.7±21.2) min and (83.2±78.8) mL, which showed no significant differences when compared to (159.1±19.8) min and (92.1±82.7) mL in the control group (P>0.05). In the observation group, the time to primary bed-off activity after operation, time of bed-off activity per week, the time to anal exhaust after operation and postoperative hospital stay were (2.6±0.8), (5.3±0.8), (2.7±0.7) and (10.3±1.7) days respectively, which were significantly better than (3.3±0.6), (3.3±1.2), (3.5±1.1) and (12.4±1.0) days in the control group (P < 0.05). The frequency of calls for nursing per week, the frequency of dressing change per week, the cost of dressing change per week and the complaint rate of patients in the observation group were (2.5±1.1) times, (2.4±0.6) times, (60.7±7.3) Yuan RMB and 0.29% (1/34) respectively, which were significantly lower than (14.8±2.8) times, (11.4±2.0) times, (147.7±26.2) Yuan RMB and 75.76% (25/33) in the control group (P < 0.05).
    Conclusion  Self-made portable leak-proof drainage bag has a significant effect in preventing and treating ascites leakage after laparoscopic splenectomy and pericardial devascularization, and it can not only reduce the workload of nursing staffs and clinicians, but also can improve the compliance of postoperative nursing, promote rapid postoperative recovery, and increase satisfaction degree.

     

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