“五精准一提高”护理模式在腹腔镜低位或超低位直肠癌根治术围术期的临床应用  

Perioperative application of "5-precision and 1-development" nursing mode in laparoscopic surgery for low rectal cancer without abdominal incision

作　　者：陈彩玲 郝雪梅 王筱君 张冬梅 Chen Cailing;Hao Xuemei;Wang Xiaojun;Zhang Dongmei(Department of General Surgery,2Operating Room;PLA Army General Hospital,Beijing 100700,China)

机构地区：[1]原陆军总医院普通外科,北京100700 [2]原陆军总医院麻醉科,北京100700

出　　处：《中华结直肠疾病电子杂志》2018年第6期593-596,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：国家自然科学基金项目(No.30772118,No.81041025)

摘　　要：目的探讨"五精准一提高"护理模式在腹腔镜低位或超低位直肠癌根治术围术期的临床应用效果。方法选取2010～2017年施行低位或超低位直肠癌根治术共216例为观察组,选取2002～2009年施行低位或超低位直肠癌根治术共212例为对照组,分析两组临床护理资料,术后组间并发症发生率比较采用卡方检验。结果比较观察组与对照组术后的并发症发生率,观察组并发症发生共29例,对照组共64例,两组比较,差异有统计学意义(X^2=17.677,P <0.001)。观察组与对照组比较术后导管护理相关不良事件发生率:尿管逆行感染、尿潴留、拔出尿管排尿障碍事件分别为7例和13例;腹腔引流管脱落、引流异常事件分别为5例和8例;静脉营养导管感染致发烧、脱落事件分别为3例和6例;两组比较差异有统计学意义(X^2=4.055,P=0.044)。结论 "五精准一提高"护理模式在腹腔镜低位或超低位直肠癌根治术围术期的临床应用与常规护理模式比较,能有效预防和降低围术期的并发症和不良事件发生率,促进患者快速康复,显著提高了临床护理质量。ObjectiveTo investigate the clinical outcome of ″5-precision and 1-development″ nursing mode in laparoscopic surgery for low rectal cancer without abdominal incision. MethodsFrom January 2010 to December 2017, 216 patients underwent laparoscopic surgery for low rectal cancer without abdominal incision were divided into experimental group with ″5-precision and 1-development″ nursing mode. From 2002 to 2009, 212 patients underwent conventional surgery for low rectal cancer were divided into control group with usual nursing, two groups of clinical nursing data were analysed. The complication rate were compared by using chi square test. ResultsComparing the incidence of complications between the observation group and the control group, there were 29 cases of complications in the observation group and 64 cases in the control group. There was significant difference between the two groups （χ2=17.677, P〈0.001）. The incidence of adverse events related to catheter nursing after operation was compared between the observation group and the control group： retrograde infection of urinary catheter, retention of urine and removal of urinary catheter were 7 cases and 13 cases respectively; abdominal drainage tube falling off and abnormal drainage events were 5 cases and 8 cases respectively; fever and abscission caused by venous nutrition catheter infection were 3 cases and 6 cases respectively. There were significant differences between the two groups （χ2=4.055, P=0.044）. ConclusionCompared with conventional nursing mode, ″5-precision and 1-development″ nursing mode in laparoscopic surgery for low rectal cancer without abdominal incision could decrease rates of complications and nursing adverse events, and could promote patients′ recovery with better nursing quality.

关 键 词：护理 腹腔镜 直肠癌根治 肿瘤 围术期 

分 类 号：R473.73[医药卫生—护理学]