| ObjectiveThis study investigated the postoperative recovery status of patients undergoing laparoscopic cholecystectomy,combined with a multidisciplinary cooperative management model to provide nursing intervention for patients undergoing laparoscopic cholecystectomy,and analyzed the influence of multidisciplinary cooperative management model on postoperative recovery of patients undergoing laparoscopic cholecystectomy In order to provide a basis for the formulation of postoperative rehabilitation intervention programs for patients with laparoscopic cholecystectomy.MethodsThis study consists of two parts.The first part is the recovery status of patients undergoing laparoscopic cholecystectomy.518 patients of 3 top-tier hospitals in Nanjing to undergo laparoscopic cholecystectomy from January 2019 to December 2019 were enrolled as the research object.The general information questionnaire,the disease-related questionnaire,the Houston pain questionnaire,the pain visual analog scale,the Pittsburgh sleep quality index,the Hamilton anxiety scale and the Hamilton depression scale were used to perform questionnaire investigation to patients.Besides,perioperative indicators,postoperative complications and serological indicators were recorded to summarize the basic situation of postoperative recovery of patients undergoing laparoscopic cholecystectomy;the second part is the impact of the multidisciplinary management model on postoperative recovery of patients undergoing laparoscopic cholecystectomy,selected from January 2020 to 2020 During June,180 patients who underwent laparoscopic cholecystectomy in our hospital were the subjects of study.According to the patients’ admission number,they were divided into the control group and the intervention group by a random number table.The control group received routine clinical care mode,and the intervention group implemented multidisciplinary cooperative management mode intervention.A multidisciplinary cooperative management group was established to conduct preoperative treatment for patients Publicity and education,perioperative care,diet care,sports care,etc.,compared the pain,sleep quality,anxiety,depression,perioperative indicators,postoperative complications and nursing satisfaction of the two groups of patients before and after care.Results（1）A total of 435 patients out of 518 patients had pain symptoms.The incidence of postoperative pain was 83.98%.The postoperative HPOI score and VAS score were（3.12±0.58）points and（3.47±0.76）points,respectively.252 patients had mild pain,accounting for 57.93%,and 273 patients had incision pain,accounting for 62.76%.（2）Postoperative sleep: The total postoperative PSQI score of 518 patients was（12.66±3.87）points,of which the highest score in the dimension of falling asleep time was（2.21±0.59）points,and when the PSQI score exceeded 7 points,it was determined that there was sleep It was found that 348 of the 518 patients had sleep disorders,and the incidence of sleep disorders was67.18%.（3）The HAMA and HAMD scores of 518 patients were relatively high after the operation.The HAMA or HAMD scores of more than 7 were judged to be anxious or depressive.As a result,422 of the 518 patients were found to be anxious.378 patients may have a depressive state,and the incidence of anxiety and depression were 81.47% and 72.97%,respectively.（4）Postoperative complications: A total of 18 of the 518 patients developed postoperative complications such as urinary retention,incision infection or lower limb deep vein thrombosis,with an incidence rate of 3.47%.（5）Serological indicators: CRP and IL-6 expression levels increased in 518 patients after operation（P<0.05）,it indicated that patients have different degrees of stress response after surgery.（6）The effect of multidisciplinary cooperative management on the pain scores of patients:The comparison within the group found that the HPOI score and VAS score of the two groups of patients after nursing were significantly lower than those before the nursing（P<0.05）,and the comparison between the groups found that the two groups of patients There was no significant difference between the HPOI score and VAS score before nursing（P>0.05）,while the HPOI and VAS scores of the intervention group after nursing were lower than those of the control group（P<0.05）.（7）The effect of multidisciplinary cooperative management on patients’ sleep quality:In-group comparison found that the sleep quality scores and total scores of the two groups of patients after nursing were significantly lower than those before nursing（P < 0.05）.The comparison between groups found There was no significant difference in the scores and total scores of sleep quality before nursing between the two groups（P>0.05）,while the scores and total scores of sleep quality in the intervention group after nursing were lower than those of the control group（P<0.05）.（8）The impact of multidisciplinary cooperative management on the psychological burden of patients: In-group comparison found that the HAMA score and HAMD score of the two groups of patients after nursing were significantly lower than those before nursing（P<0.05）.The comparison between the two groups found that the two groups of patients There was no significant difference between the HAMA score and HAMD score before nursing（P>0.05）,while the HAMA score and HAMD score of the intervention group after nursing were lower than those of the control group（P<0.05）.（9）The impact of multidisciplinary cooperative management on perioperative indicators:The exhaust time,eating time,defecation time,time to get out of bed and postoperative hospital stay in the intervention group were lower than those in the control group（P<0.05）.（10）The effect of multidisciplinary cooperative management on postoperative complications: During the intervention period,urinary retention and incision infection occurred in both groups,with no statistically significant difference（P>0.05）.（11）The effect of multidisciplinary cooperative management on nursing satisfaction: The total nursing satisfaction of the intervention group was 94.44%,which was significantly higher than the 83.33% of the control group（P<0.05）.Conclusions（1）After laparoscopic cholecystectomy,patients often have different degrees of pain,poor sleep quality,anxiety,depression and other bad moods.（2）Multidisciplinary cooperative management can effectively reduce the postoperative pain scores of patients,improve the quality of patients’ sleep,help regulate patients’ anxiety,depression and other unhealthy emotions,shorten the patient’s recovery time,and improve clinical nursing satisfaction.It should be widely used and promoted in clinical practice. |
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