腹腔镜和开腹胃癌根治术患者围术期护理的比较  

Comparison of Perioperative Nursing Care of Gastric Cancer Patients with Laparoscopyassisted and Open Radical Gastrectomy

作　　者：饶芸[1] 骆群[1] 程琳[1] 李雪玲[1] 孙梯业[1] 余佩武[1] 

机构地区：[1]第三军医大学西南医院普通外科微创胃肠外科中心,重庆400038

出　　处：《解放军护理杂志》2008年第20期4-6,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的比较腹腔镜和开腹胃癌根治术患者术后恢复情况,探讨两种胃癌根治术患者的围术期护理方法。方法对比分析2004年3月至2007年9月我科339例腹腔镜胃癌根治术和同期284例开腹胃癌根治术的病例,比较两组患者术后疼痛、恢复情况及护理措施。结果腹腔镜组患者术后疼痛程度明显低于开腹组,开始下床活动时间、进流质时间均早于开腹组,差异有统计学意义(P<0.01);腹腔镜组患者术后肛门排气、排便、拔除胃管的时间及平均住院日均少于开腹组患者,差异有统计学意义(P<0.05);腹腔镜组患者术后并发症发生率为8.85%,开腹组术后并发症发生率为9.86%,两者差异无统计学意义(P>0.05)。结论腹腔镜胃癌根治术相对传统开腹手术而言具有创伤小、术后恢复快等优点,其围术期护理的关键在于心理护理、术后病情观察和加强健康教育及饮食指导等。Objective To compare postoperative recovery of patients with laparoscopy-assisted and open radical gastrectomy and explore the methods of perioperative nursing care for patients with laparoseopy-assisted surgery and open radical gastrectomy. Methods Postoperative pain and recovery of two groups of patients with laparoscopy-assistedradical gastrectomy （n = 339） and opern radical gastrectomy（ n =284） in our department from March 2004 to Septermber 2007 were compared. Results The degree of postoperative pain of patients with laparoscopy-assisted radical gastrectomy was significantly slighter and time of starting getting off bed and eating was greatly earlier than that of patients with opern radical gastrectomy（ P 〈0.01）. Time of starting passing gas by anus and defecation, removing nasogastric tube and average days of hospital lization were significantly earlier or shorter than that of opern radical gastrectomy group（ P 〈0.05）. Rate of postoperative complication in laparoscopy-assisted radical gastrectomy group was 8. 85%, lower than 9.86% in the opern radical gastrectomy group and there was no significant difference（ P 〉0.05）. Conclusion Compare with open surgery, laparoscopy-assisted radical gastrectomy has the advantages of minimally invasive and quick postoperative recovery. The key points of its perioperatire nursing care were psychological support, observation on patient＇ s conditions after surgery, health teaching and diet instruction.

关 键 词：腹腔镜手术 胃癌 护理 围手术期 

分 类 号：R473.6[医药卫生—护理学]