延续性护理对胃大部切除术老年患者出院后早期并发症的影响  

Effects of continuity care on early complications in discharged elderly patients after subtotal gastrectomy

作　　者：朱燕华[1] 刘汉伟[2] 陈超琳[3] 黄小玲[4] 

机构地区：[1]中山大学附属第五医院普外三科,广东519000 [2]中山大学附属第五医院神经科 [3]中山大学附属第五医院手术室 [4]中山大学附属第五医院肺功能室

出　　处：《中国急救复苏与灾害医学杂志》2015年第8期728-731,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨延续性护理对老年人胃大部切除术后早期并发症的影响。方法收集165例胃大部切除老年患者，随机分治疗组（82例）和对照组（83例），两组出院前均予外科常规护理，治疗组出院后续予延续性护理。记录患者的一般临床资料和出院前后并发症，统计分析患者的年龄、性别、基础疾病、手术方式、精神状态及炎症因子等因素与并发症的相关性，比较出院后两组患者的治疗依从性、再住院率、并发症和血清指标变化。结果入组患者出院时共57例出现并发症，研究显示除年龄外，性别、手术时间和方式、胃大切类型、精神状态、基础疾病均与并发症相关，术后贫血及炎症因子升高者更易有并发症；延续性护理后患者的治疗依从性、RBC计数、HGB和ALB均升高，CRP下降，并发症减少及再住院率降低。结论胃大切术后早期并发症与多因素相关，出院后延续性护理能有效提高老年人胃大切术后治疗依从性和临床疗效，减少术后并发症，该护理模式值得临床推广。Objective To investigate the effects of continuing nursing on early complications of elderly patients after subtotal gastrectomy. Methods One hundred and sixty-five patients aged ≥60 after subtotal gastrectomy because of peptic ulcer or gastric tumors were randomly divided into 2 groups： treatment group （82 cases） and control group （83 cases）. Prior to discharge all patients received routine nursing care, including keeping patient＇s diary, and continuity care, including health education, guide for diet, exercise, and drug taking, and knowledge about prevention of complications, was given to the patients of the treatment group in addition. Relevant data were analyzed retrospectively. Results Fifty seven of the 165 patients suffered from different complications. Age, gender, operation time and mode, mental status, underlying diseases, and postoperative anemia and elevated inflammatory factors were correlated with complications. Compared with the control group, the RBC count, and HGB level were significantly higher, and the rehospitalization rate, C-reactive protein level, and complication rate were significantly lower in the treatmeat group. Conclusion Multiple factores are associated with early complications after subtotal gastrectomy. Continuity care effectively raises the post-discharge treatment compliance and clinical effects, and reduces the early postoperative complication rate of the aged patients after subtotal gastrectomy.

关 键 词：胃大部切除术 老年人 延续性护理 早期并发症 

分 类 号：R47[医药卫生—护理学]