Nursing observation of patients undergoing tension-free inguinal hernia repair treatedby 4C mode in day surgery
4C模式在日间手术治疗无张力腹股沟疝修补术患者的护理观察

摘要

目的 针对日间手术治疗无张力腹股沟疝修补术患者的护理作出分析，详细探讨4C模式的护理效果。方法 从本院2022年5月~2023年5月期间，行日间手术治疗无张力腹股沟疝修补术的患者，以患者自主参与意愿所选的78例用于研究，给予患者随机分组实施护理，一组有患者39人接受常规护理模式（常规组），另一组39例患者应用4C模式护理（4C组），对比观察2组患者症状改善时间、术后疼痛情况、出院后日常生活活动能力（MBI）及术后并发症。结果 4C组患者的肠胃蠕动时间、肛门排气时间、下床活动时间及术后进食时间，与常规组患者的各项症状改善时间相比要明显较短，（p＜0.05）；通过评估2组患者术后3d~15d的疼痛情况，4C组患者各个阶段VAS评分均显著低于常规组患者，（p＜0.05）；患者出院时、出院后1周~3个月进行随访，4C组患者的MBI评分相比常规组患者显著更高，（p＜0.05）；4C组患者的术后并发症（腹胀、尿潴留及切口感染）发生率2.56%，常规组患者术后并发症发生率15.38%，相比明显4C组更低，（p＜0.05）。结论 对于日间手术治疗无张力腹股沟疝修补术患者的护理，应用4C模式的效果最为理想，可有效减轻患者的术后疼痛，促进症状尽快改善，值得推广。

Abstract

Objective To analyze the nursing of tension-free inguinal hernia repair patients treated by day surgery, and discuss the nursing effect of 4C mode in detail.
Methods From May 2022 to May 2023 in our hospital, 78 patients who underwent tension-free inguinal hernia repair during day surgery were selected for the study, and the patients were randomly assigned to receive nursing care. 39 patients in one group received routine nursing mode (routine group). The other group of 39 patients were treated with 4C mode of nursing (4C group), and the symptom improvement time, postoperative pain, post-discharge activity of daily living (MBI) and postoperative complications were compared between the two groups.
Results The improvement time of gastrointestinal peristalsis, anal exhaust time, getting out of bed and postoperative eating time in 4C group was significantly shorter than that in conventional group (p < 0.05). The VAS scores of patients in group 4C were significantly lower than those in the conventional group at all stages by evaluating the pain status of patients in the 2 groups at 3d-15d after surgery (p < 0.05). The patients were followed up at discharge and 1 week to 3 months after discharge, and the MBI score of 4C group was significantly higher than that of conventional group (p < 0.05). The incidence of postoperative complications (abdominal distension, urinary retention and incision infection) in 4C group was 2.56%, and 15.38% in conventional group, which was lower than that in obvious 4C group (p < 0.05).
Conclusion   The application of 4C mode is the most ideal for the nursing of patients with tension-free inguinal hernia repair treated by day surgery, which can effectively reduce the postoperative pain of patients and promote the improvement of symptoms as soon as possible, and is worth promoting.