早期进食促进肝癌患者术后康复的临床护理研究  

Clinical nursing research on e nhanced postoperative recovery of patients with liver cancer by early stage feeding

作　　者：张玲[1] 黄家丽[1] 乔晓斐[1] 李艳[1] 陈璐[1] 李建生[2] 马金良[2] 荚卫东[2] 

机构地区：[1]安徽省立医院肝脏外科肝胆胰外科安徽省重点实验室,合肥市230001 [2]安徽省立医院肝脏外科,合肥市230001

出　　处：《实用肝脏病杂志》2013年第6期536-538,共3页Journal of Practical Hepatology

摘　　要：目的探讨早期进食对促进肝癌患者术后快速康复的影响。方法随机将60例肝癌肝切除术后患者分成两组:早期进食组30例(A组),常规进食组30例(B组),比较两组患者术后肝功能、胃肠道功能恢复情况、感染率、并发症发生率、营养费用、睡眠质量及住院时间。结果早期进食组患者肠鸣音恢复时间(25.51±4.64)h、肛门排气时间(36.22±5.71)h以及首次排便时间(51.32±7.93)h与常规进食组(41.63±6.16)h,(58.44±7.94)h,(72.83±9.91)h相比有统计学差异(P<0.05);术后第1天肝功能指标差异无显著意义(P>0.05);术后第5天早期进食组谷丙转氨酶(63.22±18.76)U/L、总胆红素(20.12±5.76)μmol/L和直接胆红素(12.46±5.28)μmol/L水平较低,白蛋白(36.43±4.55)g/L水平较高,与对照组[(78.31±20.56)U/L,(25.33±6.26)μmol/L,(16.51±7.35)μmol/L,(31.91±3.66)g/L]相比差异均有统计学意义(P<0.05);两组术后平均睡眠时间(7.9±1.6)h对(6.0±1.2)h、胃肠道不适(10%对50%)、感染率(6.67%对26.67%)、术后营养费用(1000±433.5)元对(2200±493.4)元、住院时间(7.21±2.21)d对(8.98±3.14)d比较差异有统计学意义(P<0.05)。结论肝癌肝切除术后早期饮食营养护理计划是更好的围手术期护理方案,安全可行,值得临床上进一步扩大验证。Objective To explore the effect of early stage feeding on the patients with liver cancer after operation. Method Sixty liver cancer patients were randomly divided into early stage feeding group （Group A, n=30）and conventional feeding group（Group B,n=30）. The liver function after operation,bowel movement recovery duration,postoperative infectious rate,postoperative morbidity,cost of nutritional support,sleep time per day and du-ration in hospital were compared between the two groups. Results Gastrointestinal tract discomfort rate（10%）,in-fection rate（6.67%）,nutrition cost（1000±433.5）yuan,bowel movement recovery duration（51.32±7.93）hand duration in hospital （7.21±2.21）d in the patients of group A were significantly lower than those in group B （50%,26.67%, （2200±493.4）yuan,（72.83±9.91）h,（8.98±3.14）d,（P＆lt;0.05）,sleep time per day （7.9±1.6）h in patients of group A were significantly longer than that in group B （6.0±1.2）h,（P＆lt;0.05）,and recovery of liver function for patients of group A were significantly better than those in group B[ALT（63.22±18.76）U/L vs.（78.31±20.56）U/l,TBIL （20.12±5.76）μmol/L vs.（25.33±6.26）μmol/L,CB（12.46±5.28）μmol/L vs.（16.51±7.35）μmol/L,ALB（36.43±4.55）g/L vs. （031.91±3.66g/L）]. Conclusion Early nutrition care plan is better for patients with liver cancer after hepatecto-my in perioperative period,which is safe and feasible and worthy of further clinical application.

关 键 词：早期进食 肝癌患者 术后康复 临床护理 统计学差异 并发症发生率 首次排便时间 肛门排气时间 

分 类 号：R735.7[医药卫生—肿瘤]