基于快速康复理念的护理干预对胃癌根治术患者术后恢复的影响
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摘要
目的探讨基于快速康复理念的护理干预对胃癌根治术患者术后恢复的影响效果。方法选择2016年9月至2018年9月于我院接受胃癌根治术的患者91例作为研究对象,随机将其分为对照组42例和观察组49例,对照组给予常规护理,观察组给予基于快速康复理念的护理干预。比较两组患者术后康复时间、炎性指标、免疫功能变化、并发症发生率。结果护理干预后,观察组患者肛门恢复排气、空肠营养管拔除、经口流质饮食、完全半流饮食、下床活动时间均明显短于对照组(P <0. 05),炎性指标优于对照组(P <0. 05),咽痛、呕吐、炎性肠梗阻、腹胀、感染和吻合口瘘并发症发生率低于对照组(P <0. 05)。护理干预前,两组患者免疫功能比较差异无统计学意义(P> 0. 05);护理干预后,两组患者免疫功能较干预前降低(P <0. 05),观察组免疫功能优于对照组(P <0. 05)。结论胃癌根治术患者使用基于快速康复理念的护理干预有助于缩短术后恢复时间、提高免疫力,降低并发症发生率。
Objective To explore the effect of nursing intervention based on fast track surgery concept on postoperative recovery of patients undergoing radical gastrectomy. Methods To select 91 cases of patients who underwent radical gastrectomy in our hospital from September 2016 to September 2018 as the study subjects. They were divided into control group with 42 patients and observation group with 49 patients randomly. The control group was treated with routine nursing,while the observation group was given nursing intervention based on fast track surgery concept. The recovery time,inflammatory index,immune function changes,and complication rate of the two groups were compared. Results After the nursing intervention,the anus recovery venting,jejunal feeding tube removal,oral fluid diet,complete semi-flow diet,and time to get out of bed in the observation group were significantly shorter than that of the control group( P < 0. 05). The inflammatory index was superior to that of the control group( P < 0. 05). The sore throat,vomiting,inflammatory bowel obstruction,bloating,infection,and complication incidence rate of anastomotic leakage were lower than that of the control group( P < 0. 05).Before the nursing intervention,there was no significant difference in the immune function between the two groups( P > 0. 05). After the nursing intervention,the immune function of the two groups was lower than that before the intervention( P < 0. 05),and the immune function of the observation group was better than that of the control group( P < 0. 05). Conclusion Applying nursing intervention based on fast track surgery concept for patients with radical gastrectomy can help shorten postoperative recovery time,and improve immunity. Meanwhile,it also can reduce the incidence rate of complications.
Objective To explore the effect of nursing intervention based on fast track surgery concept on postoperative recovery of patients undergoing radical gastrectomy. Methods To select 91 cases of patients who underwent radical gastrectomy in our hospital from September 2016 to September 2018 as the study subjects. They were divided into control group with 42 patients and observation group with 49 patients randomly. The control group was treated with routine nursing,while the observation group was given nursing intervention based on fast track surgery concept. The recovery time,inflammatory index,immune function changes,and complication rate of the two groups were compared. Results After the nursing intervention,the anus recovery venting,jejunal feeding tube removal,oral fluid diet,complete semi-flow diet,and time to get out of bed in the observation group were significantly shorter than that of the control group( P < 0. 05). The inflammatory index was superior to that of the control group( P < 0. 05). The sore throat,vomiting,inflammatory bowel obstruction,bloating,infection,and complication incidence rate of anastomotic leakage were lower than that of the control group( P < 0. 05).Before the nursing intervention,there was no significant difference in the immune function between the two groups( P > 0. 05). After the nursing intervention,the immune function of the two groups was lower than that before the intervention( P < 0. 05),and the immune function of the observation group was better than that of the control group( P < 0. 05). Conclusion Applying nursing intervention based on fast track surgery concept for patients with radical gastrectomy can help shorten postoperative recovery time,and improve immunity. Meanwhile,it also can reduce the incidence rate of complications.
引文
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[13]张漪.综合护理干预对肿瘤化疗患者免疫功能及负面情绪的影响[J].护理实践与研究,2018,15(10):99-100.
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[2]Liu S,Gu X,Zhu L,et al.Effects of propofol and sevoflurane on perioperative immune response in patients undergoing laparoscopic radical hysterectomy for cervical cancer[J].Medicine,2016,95(49):5479-5484.
[3]陶为杰,石小举,孙晓东,等.快速康复外科理念在肝移植围手术期应用的研究进展[J].中华肝胆外科杂志,2017,23(1):60-63.
[4]章琼,李笑蕾.快速康复外科理念在甲状腺癌根治术患者围手术期护理中的应用[J].护理实践与研究,2018,15(24):90-91.
[5]华长星,崔云甫.加速康复外科在胰十二指肠切除术中的应用进展[J].中华外科杂志,2016,54(10):797-800.
[6]陈其余,林芝,马香爱.围手术期护理干预对预防胃癌根治术患者深静脉血栓形成的效果研究[J].中国急救医学,2016,36(11)::283-284.
[7]谢春燕.PDCA管理对腹腔镜胃癌根治术患者术后胃肠功能及生活质量的影响[J].广东医学,2015,36(8):1303-1305.
[8]王晓龙,宿华威,赵志慧,等.腹腔镜胃癌根治术的研究进展[J].现代生物医学进展,2015,15(10):1947-1949.
[9]程康文,王贵和,束宽山,等.腹腔镜胃癌根治术中应用快速康复外科理念的研究[J].腹腔镜外科杂志,2016,21(4):292-296.
[10]徐瑜杰,王震,陈俊强.快速康复外科在胃癌根治术中应用的系统评价[J].中国普外基础与临床杂志,2015,22(4);423-433.
[11]王祥安,虞黎明,范纪昌,等.加速康复外科应用于胃癌根治术对机体免疫功能影响Meta分析[J].中国实用外科杂志,2015,35(10):1108-1112.
[12]董刚,晁威,冯方栋,等.快速康复外科理念用于胃癌根治术患者的效果观察[J].中外医学研究,2016,14(24):154-156.
[13]张漪.综合护理干预对肿瘤化疗患者免疫功能及负面情绪的影响[J].护理实践与研究,2018,15(10):99-100.
[14]王艳英,马玉磊,管艳杰,等.乳腺癌患者围手术期心理应激与免疫功能的关系[J].中国妇幼保健,2017,32(17):4099-4103.
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