快速康复路径在原发性肝癌患者围手术期的应用  

Application of fast-track pathway in perioperative patients with primary hepatic carcinoma

作　　者：任春霞[1,2] 李伦兰[3] 丁萍[3] 王丽[1] 汪红霞[1] 吴乐[1] 范引光[2] 

机构地区：[1]安徽医科大学第一附属医院肝胆胰外科一病区,安徽合肥230022 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,安徽合肥230032 [3]安徽医科大学第一附属医院护理部,安徽合肥230022

出　　处：《中华疾病控制杂志》2016年第6期600-603,608,共5页Chinese Journal of Disease Control & Prevention

基　　金：安徽省自然科学基金项目(1308085MHl51);安徽医科大学第一附属医院新技术新项目(2013年)

摘　　要：目的探讨基于快速康复外科理念的临床护理路径在原发性肝癌患者围手术期的应用效果。方法将87例原发性肝癌患者按入院时间先后分为对照组(45例)和干预组(42例),对照组接受常规肝癌围手术期护理,干预组采用快速康复护理路径标准化管理。观察比较两组患者围手术期焦虑自评量表(self-rating anxiety scales,SAS)得分、疼痛评分、术后不适与并发症发生率、术后住院时间、住院费用及再入院率的差异。结果干预组有39例和对照组43例患者完成本研究。干预组SAS得分和疼痛评分低于对照组,差异均有统计学意义(均有P<0.05);两组术后不适和大部分并发症发生率、住院费用及再入院率比较差异均无统计学意义(均有P>0.05),而干预组肺部感染率低于对照组、术后住院时间短于对照组,差异均有统计学意义(均有P<0.05)。结论快速康复护理路径标准化管理有助于减轻肝癌患者手术应激和焦虑心理、缩短康复周期,是安全有效的。Objective To evaluate the effect of clinical nursing pathway based on fast-track surgery in periopera- tire patients with primary hepatic carcinoma （PHC）. Methods A total of 87 PHC patients undergoing elective hepatecto- my were enrolled, and divided into two groups by admission time, namely the control group （45 cases） and the experimen- tal group （42 cases）. The patients in the experimental group participated in clinical nursing pathway （CNP） based on the fast-track surgery while the cases in the control group received traditional perioperative nursing care of hepatectomy. Level of perioperative anxiety and postoperative pain, discomfort and complications, hospital stay, costs and re-admission rate were measured. Results Final analysis included 39 patients in the experimental group and 43 patients in the control group. Compared with the control group, scores of self-rating anxiety scales （SAS） and pain were significantly lower in the experimental group （ all P 〈 0. 05 ）. No significantly differences between the two groups were observed regarding postopera- tive discomfort and most of complications, hospitalization expense and re-admission rates （ all P 〉 0.05 ） while pulmonary infection rate was lower and hospital stay was shorter in the experimental group （ all P 〈 0. 05 ）. Conclusions Application of fast-track nursing pathway in perioperative patients with PHC can reduce operative stress and anxiety, achieve faster re- covery, which is safe and effective.

关 键 词：康复护理 临床护理研究 肝肿瘤 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤] R493.3[医药卫生—临床医学]