循证护理在高龄老年胃癌患者腹腔镜切除并发症预防与术后康复中的作用  

Effect of Evidence-based Nursing on Postoperative Recovery and Complication Prevention in the Elderly with Radical Surgery for Gastric Cancer Under Laproscope

作　　者：张钦[1] 李芳芳[1] 唐奋 ZHANG Qin;LI Fangfang;TANG Feng(The First Affiliated Hospital of Anhui Medical University,Anhui Hefei 230022,Chin)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230022

出　　处：《中医药临床杂志》2018年第6期1157-1160,共4页Clinical Journal of Traditional Chinese Medicine

摘　　要：目的:探讨循证护理模式在高龄老年胃癌患者腹腔镜切除并发症预防与术后康复中作用。方法:回顾性分析2011年1月~2015年12月高龄老年胃癌患者86例,随机分为常规护理组40例和循证护理组46例。建立循证护理小组,进行循证问题、循证支持和实施。比较2组术后恢复情况指标(如肛门排气、排便、下床活动、进食和住院时间)和主要并发症(如肺部感染、腹腔出血、吻合口瘘、吻合口梗阻、皮下气肿、胃瘫、下肢静脉血栓)有无差异。结果:循证护理组患者术后恢复情况指标如肛门排气、排便、下床活动、进食、平均住院时间均少于常规护理的患者(t=1.139,P<0.05;t=2.601,P<0.05;t=1.021,P<0.05;t=2.735,P<0.05;t=3.323,P<0.05),术后主要并发症如肺部感染、皮下气肿、胃瘫、下肢静脉血栓发生率显著低于常规护理的患者(χ2=6.413,P<0.05;χ2=1.653,P<0.05;χ2=5.478,P<0.05;χ2=3.124,P<0.05)。结论:个体化的循证护理模式能够降低高龄老年胃癌患者腹腔镜胃癌根治术后并发症发生,有利于患者术后康复,对于高龄老年患者手术并发症预防具有重要的临床应用价值。Objective： To explore the effect of evidence-based nursing on postoperative recovery and complication prevention in the elderly with radical surgery for gastric cancer under laproscope. Methods： The clinical data from 86 elderly patients with gastric cancer were retrospectively analyzed from Jan. 2011 to Dec. 2015. 86 cases were randomly divided into the routine nursing group（40 cases） and the evidence-based nursing group（46 cases）. The evidence-based problems and support were carried out by establishing the evidence-based group. The time including the anus exhaust,defecation, off-bed activity, eating and hospital stays were compared with the two groups after operation. The postoperative complications including pulmonary infection, abdominal bleeding, anastomotic fistula, anastomotic obstruction,subcutaneous emphysema, gastric paralysis, vein thrombosis of lower limbs were observed between the two groups.Results： The time of the anus exhaust, defecation, off-bed activity, eating and hospital stays in the evidence-based nursing group was respectively less than that of the routine nursing group（t=1.139, P〈0.05; t=2.601, P〈0.05; t=1.021,P〈0.05; t=2.735, P〈0.05; t=3.323, P〈0.05）. The main complications including pulmonary infection, subcutaneous emphysema, gastric paralysis, vein thrombosis of lower limbs in the evidence-based nursing group were respectively lower than that of the routine nursing group（χ2=6.413, P〈0.05; χ2=1.653, P〈0.05; χ2=5.478, P〈0.05; χ2=3.124, P〈0.05）.Conclusion： Individualization mode of evidence-based nursing can decrease the postoperative complications for laparoscopic gastrectomy in elderly patients with gastric cancer.It is beneficial to postoperative rehabilitation and complications prevention in elderly patients wit h gastric cancer.

关 键 词：老年患者 腹腔镜 胃癌根治术 循证护理 并发症 

分 类 号：R711[医药卫生—妇产科学]