快速康复护理理念在结直肠癌手术患者围术期护理中对胰岛素抵抗的影响  

Effect of rapid rehabilitation nursing concept in perioperative nursing of patients with colorectal cancer surgery

作　　者：陈美玲[1] 曾凤美[1] 李坤旺 吴莺燕[2] 

机构地区：[1]浙江省丽水市人民医院手术室,浙江丽水323000 [2]浙江省丽水市人民医院肛肠科,浙江丽水323000

出　　处：《中国现代医生》2016年第1期146-149,154,共5页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(2013KYA235)

摘　　要：目的分析快速康复护理理念在结直肠癌手术患者围术期护理中对胰岛素抵抗的影响。方法随机选取我院2012年5月~2014年5月收治的结直肠癌择期手术患者82例,采用随机数字表法分为两组：观察组和对照组,每组各41例。观察组采用快速康复护理理念进行围手术期护理,对照组采用常规护理模式;观察对比两组患者术后各项指标恢复情况、术后并发症发生情况以及胰岛素抵抗指数（HOMA-IR）。结果观察组术后胃管留置、尿管留置、进食、肛门排气时间、首次排便时间及住院时间均较对照组明显缩短,观察组医疗费用也较对照组明显减少,但是二者尿管重新安放例数和再住院例数相差无几;观察组不良反应发生率为9.76%,而对照组高达29.27%,差异具有统计学意义（P=0.026）;观察组FPG、FINS以及HOMA-IR分别为（5.1±0.6）mmol/L、（2.3±0.4）μU/m L、（1.0±0.1）,对照组分别为（6.3±0.7）mmol/L、（2.6±0.3）μU/m L、（1.2±0.2）,观察组FPG、FINS和HOMA-IR均较对照组明显降低,差异具有统计学意义（P〈0.05）。结论采用快速康复护理理念在结直肠癌患者围手术期护理中可以有效缩短患者术后恢复时间,降低不良反应发生率和胰岛素抵抗水平,成效显著,值得推广。Objective To discuss and analyze the effect of rapid rehabilitation nursing concept in perioperative nursing of patients with colorectal cancer surgery. Methods A total of 82 cases of patients with rectal cancer underwent elective surgery in our hospital from May 2012 to May 2014 were randomly selected, who were divided into two groups according to random digital table method, the observation group and the control group, each group 41 cases. The observation group were given the concept of rapid rehabilitation nursing, and the control group were given conventional nursing model. The postoperative recovery, postoperative complications, and insulin resistance index（HOMA-IR） of patients in the two groups were observed and compared. Results The indwelling catheter, indwelling gastric tube feeding, hepatic portal, first anal exhaust discharge and hospitalization time in the observation group were significantly shorter than those in the control group, and the medical cost in the observation group was than decreased significantly than that in the control group, but the numbers of patients who placed catheter again and went to stay hospital again were similar in the two groups. The incidence of adverse reactions in the observation group was 9.76%, while the control group was29.27%, so the difference was statistically significant（P =0.026）. The FPG, FINS and HOMA-IR in the observation group were respectively（5.1 ±0.6） mmol/L,（2.3 ±0.4） μU/m L,（1.0 ±0.1）, while the control group respectively（6.3 ±0.7）mmol/L,（2.6±0.3） μU/m L,（1.2±0.2）, so the FPG, FINS and HOMA-IR in the observation group were significantly lower than those in the control group, between which the differences were statistically significant（P〈0.05）. Conclusion The concept of rapid rehabilitation nursing in patients with colorectal cancer during operation can effectively shorten recovery time,reduce adverse reactions occur rate and insulin resistance levels, with remarkable effects, which is worthy of promotion.

关 键 词：快速康复护理 结直肠癌手术 围手术期护理 胰岛素抵抗 

分 类 号：R473.6[医药卫生—护理学]