The Investigation Of The Application Of Visual And Smell Stimulation & Early Stage Feeding On The Patients After Laparoscopic Cholecystectomy Surgery

Objective: The conception of fast-track surgery(FTS), advocated by Kehlet since 2001, gradually draws the attention of the clinical professionals. Preoperative abnormal indwelling of gastric tube and urine tube with postoperative early stage feeding is a very important step, but debate on the safety remains. This paper provides the different nursing and dietary guidance to the patients after laparoscopic cholecystectomy surgery and observe the effects of laparoscopic cholecystectomy surgery on the recovery of the gastrointestinal function of patients by visual and smell stimulation and early stage feeding to explore the safety and feasibility of the preoperative abnormal indwelling of gastric tube and urine tube and early stage feeding after laparoscopic cholecystectomy, therefore, to improve the comfort of patients with laparoscopic cholecystectomy, promote gastrointestinal function recovery and to spread the fast-track surgery nursing concept.Methods: Select 111 voluntary cases of patients in accordance with laparoscopic gallbladder surgery indications from the Second Hospital, Hebei medical university as the research subjects from the March 2014 to December 2014. Divide the 111 patients randomly according to the random number table into three groups: control group 36 cases, the Test group B 37 cases,Test group A 38 cases.Control group: indwell the preoperative abnormal gastric tube and urine tube by normal pattern, take low-fat liquid after the anus exhaust and gradually transit to the low-fat semifluid, normal diet.Test group B: With the preoperative abnormal indwelling of gastric tube and urine tube, taken 50 ml warm water after anesthesia awake, give warm water 100 ml after 2 hours if there is no patient discomfort complained, which can be repeated according to the patients needs. Take the fat free liquid after the intestinal functional recovery, step by step, gradually transit to regular diet;Test group A: On the basis of group B, add to visual and smell stimulation according to the dietary preference of the patients. Rate the level of pain of patients after surgery by the international general digital evaluation questionnaire(numerical rating scale, NRS), ask the recovery time of bowel sounds,incidence of hunger and thirst after the operation, exhaust time,the incidence of postoperative nausea and vomiting,comfort of three groups patients by auscultation to carries on the contrast research, then compare the differences among group.Results:1 Basic characteristics of the subjectsThere is no statistical difference among three groups of patients in terms of gender and age(P>0.05).2 The comparison of the activity of daily living of the three groups of patientsAssess the patients daily life ability with ADL scale evaluation, respectively, observe the patients back to ward(ADL0), 6 hours(ADL6), 24 hours(ADL24) score, there were no significant differences of group A and group B in three periods. Group A and group B both have significant difference compared with control group, and there is statistical difference.(P <0.05)3 The comparison of gastrointestinal functional recovery after surgery among three groups of patientsThe first time of exhaust time after the operation as the observe indicator of the gastrointestinal functional recovery. There is a improvement in the first time of exhaust time of the patients after surgery of Test group A and group B. Compared with group B, there is an ahead of time in patients of group A in terms of the first time of exhaust time and there is a very significant statistical difference(P<0.05).4.The comparison of the incidence of postoperative nausea and vomiting, patient comfort, and other indicators. The incidence of postoperative nausea and vomiting is lower in patients of Test group A and group B. The patients comfort in Test group A is higher than the test group B and control group. The patients comfort in Test group B is higher than the control group and there is statistical difference.(P<0.05)The indicators of postoperative pain level is lower in group A and group B, and there is a statistical difference(P<0.05). And there is no statistical difference(P> 0.05) in group A and group B in terms of the indicator comparison.Conclusion:1 The application of visual and smell stimulation and early stage feeding for the patients after laparoscopic cholecystectomy surgery promotes the recovery of gastrointestinal function of patients, and, to a certain extent, promote the spread of the fast-track surgery(FTS) nursing concept.2 It is safe and effective to apply the fast-track surgery(FTS) nursing concept to the patients with laparoscopic cholecystectomy3 According to the dietary habits of different patients, choose the different food stimulation modes, implement the high quality customized nursing for patients, promote the gastrointestinal functional recovery of patients, reduce the postoperative complications and improve the patients’ comfort, promote the rapid recovery of the patients.