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食管癌患者圍手術(shù)期快速康復(fù)護(hù)理的效果

2019-08-19 01:30鄧金燕倫冬美夏霞芬陳妹宜唐文婷李艷萍葉麗瑩
中外醫(yī)學(xué)研究 2019年17期
關(guān)鍵詞:快速康復(fù)外科食管癌圍術(shù)期

鄧金燕 倫冬美 夏霞芬 陳妹宜 唐文婷 李艷萍 葉麗瑩

【摘要】 目的:探討將快速康復(fù)外科應(yīng)用于食管癌患者圍術(shù)期中的效果。方法:選取2016年1月-2018年12月筆者所在醫(yī)院收治的食管癌根治術(shù)患者100例為研究對(duì)象,以隨機(jī)數(shù)字表法將其分為常規(guī)式康復(fù)組50例和快速外科康復(fù)組50例,常規(guī)式康復(fù)組按照食管癌常規(guī)康復(fù)模式開(kāi)展護(hù)理照護(hù)服務(wù),快速外科康復(fù)組則對(duì)食管癌根治術(shù)常規(guī)圍術(shù)期諸多護(hù)理舉措加以?xún)?yōu)化處置以促成患者快速康復(fù)目標(biāo)的達(dá)成。比較兩組患者術(shù)后首次排氣時(shí)間、首次排便時(shí)間、并發(fā)癥發(fā)生率、住院費(fèi)用及住院時(shí)間。結(jié)果:快速外科康復(fù)組干預(yù)后首次排氣時(shí)間、首次排便時(shí)間、并發(fā)癥發(fā)生率、住院費(fèi)用及住院時(shí)間均顯著優(yōu)于常規(guī)式康復(fù)組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論:將快速康復(fù)外科應(yīng)用于食管癌患者圍術(shù)期中,可獲得較好的促快速康復(fù)效應(yīng),降低醫(yī)療費(fèi)用。

【關(guān)鍵詞】 快速康復(fù)外科; 食管癌; 圍術(shù)期; 護(hù)理

doi:10.14033/j.cnki.cfmr.2019.17.046 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805(2019)17-0-03

【Abstract】 Objective:To explore the effect of rapid rehabilitation surgery in perioperative period of esophageal cancer patients.Method:A total of 100 patients with radical resection of esophageal cancer admitted in our hospital from January 2016 to December 2018 were selected as research objects.They were divided into the routine rehabilitation group(50 cases) and the rapid surgical rehabilitation group(50 cases) by random number table method.The routine rehabilitation group carried out nursing care services according to the routine rehabilitation model of esophageal cancer,and the rapid surgical rehabilitation group carried out many nursing care during the routine perioperative period of esophageal cancer radical surgery to achieve the goal of rapid rehabilitation of patients.The first exhaust time,the first defecation time,the incidence of complications,the hospitalization expense and the hospitalization time were compared between the two groups.Result:The time of first exhaust and defecation,the incidence of complications,the hospitalization expenses and the hospitalization time in the rapid surgical rehabilitation group were significantly better than those in the routine rehabilitation group,the differences were statistically significant(P<0.05).Conclusion:The application of rapid rehabilitation surgery in perioperative period of esophageal cancer patients can achieve better effect effect of promoting rapid rehabilitation and reduce medical costs.

【Key words】 Rapid rehabilitation surgery; Esophageal Cancer; Perioperative period; Nursing

First-authors address:Gaoyao District Peoples Hospital of Zhaoqing City,Zhaoqing 526040,China

快速康復(fù)外科指于患者整個(gè)圍術(shù)期中,將多個(gè)已獲臨床檢驗(yàn)積極有效的護(hù)理舉措與策略加以綜合應(yīng)用,盡最大努力降低受術(shù)者手術(shù)應(yīng)激度及并發(fā)癥發(fā)生率,推動(dòng)受術(shù)者康復(fù)過(guò)程的快速化安全性發(fā)展,減少住院費(fèi)用與縮短住院時(shí)間,該康復(fù)模式已在國(guó)內(nèi)外諸多手術(shù)領(lǐng)域獲得高度認(rèn)可與積極推行[1-2]。本研究擇取2016年1月-2018年12月筆者所在醫(yī)院收治的100例食管癌根治術(shù)患者為研究對(duì)象,探討將快速康復(fù)外科應(yīng)用于食管癌患者圍術(shù)期的效果,現(xiàn)報(bào)告如下。

1 資料與方法

1.1 一般資料

本研究選取2016年1月-2018年12月筆者所在醫(yī)院收治的100例食管癌根治術(shù)患者為研究對(duì)象,均確定診斷為食管癌且滿(mǎn)足手術(shù)指征,排除合并心肺嚴(yán)重疾病、脊柱畸形、糖尿病、進(jìn)食梗阻及凝血異常者。其中男55例,女45例;平均年齡(55.30±10.57)歲。以隨機(jī)數(shù)字表法將其分為常規(guī)式康復(fù)組50例和快速外科康復(fù)組50例。常規(guī)式康復(fù)組男25例,女25例;年齡42~64歲,平均(55.3±9.8)歲??焖偻饪瓶祻?fù)組男30例,女20例;年齡41~65歲,平均(56.3±10.3)歲。兩組性別、年齡等一般資料比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05),有可比性。

[4]張瓊.自我效能與自我護(hù)理聯(lián)合干預(yù)對(duì)喉癌患者術(shù)后營(yíng)養(yǎng)狀態(tài)和生活質(zhì)量的影響[J].實(shí)用醫(yī)院臨床雜志,2016,13(1):87-90.

[5]徐志娟.自護(hù)理論護(hù)理對(duì)食管癌放療患者生存質(zhì)量的影響[J].實(shí)用臨床醫(yī)藥雜志,2013,17(22):32-34.

[6] Derogar M,Orsini N,Sadr-Azodi O.Influence of major postopera-tive complications on health -related quality of life among long -term survivors of esophageal cancer surgery[J].J Clin Oncol,2012,30(14):1615-1619.

[7]何淑平,鄭惠萍.中西醫(yī)結(jié)合快速康復(fù)外科在食管癌術(shù)后康復(fù)中的應(yīng)用研究[J].現(xiàn)代消化及介入診療,2015,20(6):666-668.

[8]呂亞娟,張建東,劉振,等.放射治療對(duì)食管癌患者生活質(zhì)量的影響[J].山東醫(yī)藥,2013,53(40):34-36.

[9] Zehetner J,Demeester S R,Ayazi S,et al.Home self-dilatation foresophageal strictures[J].Dis Esophagus,2014,27(1):1-4.

[10]郭穎.食管癌放療患者質(zhì)量與效能的相關(guān)性研究[J].齊魯護(hù)理雜志,2015,21(7):68-70.

[11]周圓圓,張菊芳,蔣美琴,等.食管癌術(shù)后患者的生活質(zhì)量現(xiàn)況及其影響因素[J].解放軍護(hù)理雜志,2014,31(6):1-4.

[12]羅娟.護(hù)理干預(yù)對(duì)食管癌放療并發(fā)放射性食管炎的影響[J].齊齊哈爾醫(yī)學(xué)院學(xué)報(bào),2015,36(5):741-743.

[13]龔艷,蔣維連,崔莉青.基于堅(jiān)強(qiáng)概念的心理干預(yù)對(duì)食管癌手術(shù)患者焦慮與抑郁的影響[J].護(hù)理管理雜志,2015,15(2):125-126,131.

[14] Maryam K P,Haidar N,Nazila P.Effects of a Self- Care Education Program on Quality of Life After Surgery in Patients With Esophageal Cancer[J].Gastroenterology Nursing,2012,35(5):332-340.

[15] Sharan K,F(xiàn)ernandes D J,Prakash Saxena P U,et al.Treatment outcomes after intraluminal brachytherapy following definitive chemoradio -therapy in patients with esophageal cancer[J].Journal of Cancer Research and Therapeutics,2014,10(2):337-341.

[16]何吉,尤振兵,田文澤,等.醫(yī)護(hù)一體化護(hù)理對(duì)食管癌患者術(shù)后應(yīng)激反應(yīng)與近期生存質(zhì)量的影響[J].中華現(xiàn)代護(hù)理雜志,2014,20(28):3554-3557.

(收稿日期:2019-01-16) (本文編輯:桑茹南)

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