多学科协作联合快速康复外科护理模式在结直肠肿瘤手术中的应用与研究
|
摘要
目的探讨多学科协作联合快速康复外科护理模式在结直肠肿瘤手术中的应用效果。方法将106例结直肠肿瘤手术患者随机分为对照组(n=53)和观察组(n=53),对照组行传统围手术期护理,观察组行多协科协作快速康复外科护理模式。比较两组术后首次排气时间、术后下床活动时间、术后住院时间。结果观察组术后首次排气时间、术后下床活动时间、术后住院时间较对照组时间均短,差异均具有统计学意义(P<0.05);观察组术后并发症发生率较对照组低,差异具有统计学意义(P<0.05);观察组术后生活质量(EORTCQLQ-C30)评分较对照组高,差异具有统计学意义(P<0.05)。结论多学科协作联合快速康复外科护理模式可以加速结直肠肿瘤患者康复进程,安全性、有效性高,值得临床推广应用。
Objective To explore the application effect of multidisciplinary collaboration combined with fast-track surgery nursing mode in colorectal cancer surgery. Methods A total of 106 patients with colorectal tumor surgery were randomly divided into control group(n=53) and observation group(n=53). The control group underwent traditional perioperative nursing. The observation group underwent multi-collaborative combined with fast-track surgery nursing mode.The postoperative exhaust time, postoperative time of ambulation, and postoperative hospital stay were compared between the two groups. Results The postoperative exhaust time, postoperative time of ambulation, and postoperative hospital stay of the observation group were shorter than those in the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative complications of the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). The postoperative quality of life(EORTCQLQ-C30)score of the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Multidisciplinary collaboration combined with fast-track surgery was higher care mode can accelerate the recovery process of colorectal cancer patients, with high safety and efficiency, and worthy of clinical application.
Objective To explore the application effect of multidisciplinary collaboration combined with fast-track surgery nursing mode in colorectal cancer surgery. Methods A total of 106 patients with colorectal tumor surgery were randomly divided into control group(n=53) and observation group(n=53). The control group underwent traditional perioperative nursing. The observation group underwent multi-collaborative combined with fast-track surgery nursing mode.The postoperative exhaust time, postoperative time of ambulation, and postoperative hospital stay were compared between the two groups. Results The postoperative exhaust time, postoperative time of ambulation, and postoperative hospital stay of the observation group were shorter than those in the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative complications of the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). The postoperative quality of life(EORTCQLQ-C30)score of the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Multidisciplinary collaboration combined with fast-track surgery was higher care mode can accelerate the recovery process of colorectal cancer patients, with high safety and efficiency, and worthy of clinical application.
引文
[1]杨东林,王向东,李芹.快速康复外科对老年结直肠癌患者术后谵妄的影响[J].中国现代普外科进展,2016,19(4):313-315.
[2]吴茜,马晶晶,陈静娟.多学科协作快速康复外科护理在结直肠肿瘤手术中的应用[J].护理管理杂志,2015,15(11):800-802.
[3]Gouvas N,Tan E,Windsor A,et al.Fast-track vs standard care incolorectal surgery:A meta-analysis update[J]Interna J ColorectDis,2009,24(10):1119-1131.
[4]Kim JW,Kim WS,Cheong J,et al.Safety and efficacy of fast-tracksurgery in laparoscopic distal gastrectomy for gastric cancer:A randomized clinical trial[J].World J Surg,2012,36(12):2879-2887.
[5]Zhuang C,Ye X,Zhang X,et al.Enhanced recovery after surgery programs versus traditional care for colorectal surgery:A meta-analysis ofrandomized controlled trials[J]Dis Colon&Rectum,2013,56(5):667-678.
[6]Huang Z,Yi L,Zhong Z,et al.Comparison of fast-track versus conventional surgery protocol for patients undergoing robot-assisted laparoscopic radical prostatectomy:A Chinese experience[J].Scientific Reports,2018,8(1):8017.
[7]郭玉芝,董启超,梁晖.快速康复外科对腹腔镜结直肠肿瘤患者围术期临床指标及生活质量的影响[J].齐鲁护理杂志,2016,22(8):12-14.
[8]杨卫富,印山河,王黎.快速康复外科对腹腔镜结直肠癌手术患者胰岛素抵抗和炎性反应的影响[J].中国微创外科杂志,2017,17(5):450-454.
[9]温大翠,赵高平,杨卯竹,等.快速康复外科护理措施在结直肠癌患者围手术期的应用效果[J].解放军护理杂志,2009,26(4B):4-6
[10]Agrafiotis AC,Corbeau M,Buggenhout A,et al.Enhanced recovery after elective colorectal resection outside a strict fast-track protocol:A single centre experience[J]Int J Colorect Dis,2014,29(1):99-104.
[11]金宝玲,高建超.快速康复外科理念在胃癌患者围手术期护理中应用的效果评价[J].中国实用护理杂志,2012,28(14):54-55.
[12]鲁力,谢敏,熊治国快速康复外科在结直肠肿瘤围手术期中的应用[J].中华结直肠疾病电子杂志,2016,5(4):333-337.
[13]Liu Y.Application of fast track surgery in routine nursing for patient with colorectal cancer[J].Saudi Journal of Biological Sciences,2017,24(8):1939-1942.
[14]朱丽,赵梅珍.快速康复外科多模式镇痛在肠道手术病人中的应用[J].全科护理,2015,13(6):481-483.
[15]Compagna R,Aprea G,DE Rosa D,et al.Fast track forelderly patients:is it feasible for colorectal surgery?[J].IntJ Surg,2014,12(Suppl 2):20-22.
[16]Sammour T,Zargar-Shoshtari K,Bhat A,et al.A programme of enhanced recovery after surgery(ERAS)is acost-effective intervention in elective colonic surgery[J].N Z Med J,2010,123(1319):61-70.
[17]King PM,Blazeby J M,Ewings P,et al.The influence ofan enhanced recovery programme on clinical outcomes,costsand quality of life after surgery for colorectal cancer[J].Colorectal Dis,2006,8(6):506-513.
[18]Miller C,Campain NJ,Dbeis R,et al.Introduction of robot-assisted radical cystectomy within an established enhanced recovery programme[J].BJU International,2017,120(2):265-272.
[19]Gralla O,Haas F,Knoll N,et al.Fast-track surgery in laparoscopic radical prostatectomy:Basic principles[J].World Journal of Urology,2007,25(2):185-191.
[20]Ferguson KH,McNeil JJ,Morey AF.Mechanical and antibiotic bowelpreparation for urinary diversion surgery[J].The Journal of Urology,2002,167(6):2352-2356.
[21]Monacelli F,Signori A,Prefumo M,et al.Delirium,Frailty,and Fast-Track Surgery in Oncogeriatrics:Is There a Link?[J].Dementia and Geriatric Cognitive Disorders Extra,2018,8(1):33-41.
[2]吴茜,马晶晶,陈静娟.多学科协作快速康复外科护理在结直肠肿瘤手术中的应用[J].护理管理杂志,2015,15(11):800-802.
[3]Gouvas N,Tan E,Windsor A,et al.Fast-track vs standard care incolorectal surgery:A meta-analysis update[J]Interna J ColorectDis,2009,24(10):1119-1131.
[4]Kim JW,Kim WS,Cheong J,et al.Safety and efficacy of fast-tracksurgery in laparoscopic distal gastrectomy for gastric cancer:A randomized clinical trial[J].World J Surg,2012,36(12):2879-2887.
[5]Zhuang C,Ye X,Zhang X,et al.Enhanced recovery after surgery programs versus traditional care for colorectal surgery:A meta-analysis ofrandomized controlled trials[J]Dis Colon&Rectum,2013,56(5):667-678.
[6]Huang Z,Yi L,Zhong Z,et al.Comparison of fast-track versus conventional surgery protocol for patients undergoing robot-assisted laparoscopic radical prostatectomy:A Chinese experience[J].Scientific Reports,2018,8(1):8017.
[7]郭玉芝,董启超,梁晖.快速康复外科对腹腔镜结直肠肿瘤患者围术期临床指标及生活质量的影响[J].齐鲁护理杂志,2016,22(8):12-14.
[8]杨卫富,印山河,王黎.快速康复外科对腹腔镜结直肠癌手术患者胰岛素抵抗和炎性反应的影响[J].中国微创外科杂志,2017,17(5):450-454.
[9]温大翠,赵高平,杨卯竹,等.快速康复外科护理措施在结直肠癌患者围手术期的应用效果[J].解放军护理杂志,2009,26(4B):4-6
[10]Agrafiotis AC,Corbeau M,Buggenhout A,et al.Enhanced recovery after elective colorectal resection outside a strict fast-track protocol:A single centre experience[J]Int J Colorect Dis,2014,29(1):99-104.
[11]金宝玲,高建超.快速康复外科理念在胃癌患者围手术期护理中应用的效果评价[J].中国实用护理杂志,2012,28(14):54-55.
[12]鲁力,谢敏,熊治国快速康复外科在结直肠肿瘤围手术期中的应用[J].中华结直肠疾病电子杂志,2016,5(4):333-337.
[13]Liu Y.Application of fast track surgery in routine nursing for patient with colorectal cancer[J].Saudi Journal of Biological Sciences,2017,24(8):1939-1942.
[14]朱丽,赵梅珍.快速康复外科多模式镇痛在肠道手术病人中的应用[J].全科护理,2015,13(6):481-483.
[15]Compagna R,Aprea G,DE Rosa D,et al.Fast track forelderly patients:is it feasible for colorectal surgery?[J].IntJ Surg,2014,12(Suppl 2):20-22.
[16]Sammour T,Zargar-Shoshtari K,Bhat A,et al.A programme of enhanced recovery after surgery(ERAS)is acost-effective intervention in elective colonic surgery[J].N Z Med J,2010,123(1319):61-70.
[17]King PM,Blazeby J M,Ewings P,et al.The influence ofan enhanced recovery programme on clinical outcomes,costsand quality of life after surgery for colorectal cancer[J].Colorectal Dis,2006,8(6):506-513.
[18]Miller C,Campain NJ,Dbeis R,et al.Introduction of robot-assisted radical cystectomy within an established enhanced recovery programme[J].BJU International,2017,120(2):265-272.
[19]Gralla O,Haas F,Knoll N,et al.Fast-track surgery in laparoscopic radical prostatectomy:Basic principles[J].World Journal of Urology,2007,25(2):185-191.
[20]Ferguson KH,McNeil JJ,Morey AF.Mechanical and antibiotic bowelpreparation for urinary diversion surgery[J].The Journal of Urology,2002,167(6):2352-2356.
[21]Monacelli F,Signori A,Prefumo M,et al.Delirium,Frailty,and Fast-Track Surgery in Oncogeriatrics:Is There a Link?[J].Dementia and Geriatric Cognitive Disorders Extra,2018,8(1):33-41.