多学科联合诊治下护理干预在肝癌患者围手术期护理中的应用  

Application of nursing intervention in perioperative nursing of liver cancer patients under the multidisciplinary joint diagnosis and treatment

作　　者：席清 吴建中[1] 刘杨[1] 张爱萍[1] 赵柳[1] 刘桂月[1] 

机构地区：[1]中国人民解放军第302医院肝胆外科,北京市100039

出　　处：《护理实践与研究》2018年第4期63-65,共3页Nursing Practice and Research

摘　　要：目的:探讨多学科联合诊治下护理干预在肝癌患者围手术期护理中的应用效果。方法:选取2012年1月~2017年1月在我院行手术治疗的肝癌患者400例,随机等分为观察组和对照组,对照组给予传统围术期护理干预,观察组给予多学科联合诊治下护理干预,比较两组患者术前与术后3 d血清学指标[C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、前白蛋白(PA)以及总胆红素(TBIL)]、手术指标(手术时间、术中平均出血量与输血量)、术后恢复情况(肛门排气时间、引流时间、进食时间、术后3 d下床活动时间、平均住院时间及医疗费用)、各时间段疼痛(VAS)评分、并发症发生情况。结果:术后3 d,观察组患者CRP,ALT水平低于对照组(P<0.05),PA水平高于对照组(P<0.05),两组TBIL、手术时间、术中平均出血量与输血量比较差异无统计学意义(P>0.05),观察组肛门排气时间、引流时间、进食时间、平均住院时间均短于对照组(P<0.05),术后3 d下床活动时间明显长于对照组(P<0.05),术后疼痛评分低于对照组(P<0.05),且医疗费用、并发症总发生率低于对照组(P<0.05)。结论:在肝癌患者围手术期给予多学科联合诊治下的护理干预,可促进肝功能恢复,缓解术后疼痛,降低各种并发症风险,优化患者预后。Objective: To explore the application effect of nursing intervention in perioperative nursing of liver cancer patients under the multidisciplinary joint diagnosis and treatment. Methods: A total of 400 liver cancer patients who underwent surgical treatment in our hospital from January 2012 to January2017 were selected and randomly divided into observation group and control group. While the control group was treated with traditional perioperative nursing intervention,the observation group was treated with nursing intervention under the multidisciplinary joint diagnosis and treatment. The following aspects were compared between the two groups before and 3 days after operation: serology index [C-reactive protein( CRP),alanine aminotransferase( ALT),prealbumin( PA) and total bilirubin( TBIL) ],operative indicators( operation time,intraoperative blood loss and blood transfusion volume),postoperative recovery( anal exhaust time,drainage time,feeding time,the leaving bed time after 3 days,average length of stay and medical expenses),pain score in each time period( VAS),and complications. Results: The levels of CRP and ALT in the observation group were lower than those in the control group at three days after operation( P < 0. 05),and the level of PA was higher than that in the control group( P < 0. 05). There was not statistical significance between the two groups in TBIL,operation time,intraoperative blood loss and blood transfusion volume( P > 0. 05). Anus exhaust time,drainage time,feeding time and average length of stay were shorter than those of the control group( P < 0. 05); the leaving bed time 3 days after operation was significantly longer than that of the control group( P < 0. 05); the postoperative pain score was lower than that of the control group( P < 0. 05),as well as the medical expenses and the incidence of complications were lower than those of the control group( P < 0. 05). Conclusion: Nursing intervention in liver cancer patients during the perioperative period under multidisciplinary joint diagnosis

关 键 词：多学科联合诊治 肝癌 围手术期 护理 预后 

分 类 号：R473.73[医药卫生—护理学]