快速康复外科护理在结直肠癌NOSES手术患者中的应用探索  

Application of rapid rehabilitation surgical nursing in patients with colorectal cancer undergoing NOSES operation

作　　者：董雪 云红 汪毅 许东奎 赵志勋 王锡山 刘正 Dong Xue;Yun Hong;Wang Yi;Xu Dongkui;Zhao Zhixun;Wang Xishan;Liu Zheng(Department of VIP,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Bejing 100021,China;Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Bejing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院特需医疗部,北京100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京100021

出　　处：《中华结直肠疾病电子杂志》2020年第2期204-208,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：北京市科技计划(No.D171100002617004)。

摘　　要：目的探讨快速康复外科护理对结直肠癌NOSES术患者术后恢复效果及心理状况的影响。方法选取2018年5月至2019年3月在中国医学科学院肿瘤医院行结直肠癌NOSES手术的患者90例为研究对象。按照随机数字表法将其分为实验组和对照组,每组45例。实验组给予快速康复外科护理管理,对照组给予常规护理。观察术后首次排气、排便、离床活动、住院时间及患者焦虑抑郁程度的组间差异。结果入院时,两组焦虑评分(t=0.744,P=0.461)和抑郁评分(t=-1.879,P=0.066)差异均无统计学意义,具有可比性。实验组在术后48 h焦虑评分低于对照组(t=-5.85,P<0.01)、抑郁评分低于对照组(t=-6.04,P<0.01),差异有统计学意义。实验组术后首次排气时间短于对照组(t=-2.32,P=0.025),首次排便时间短于对照组(t=-2.48,P=0.017),首次离床活动时间早于对照组(t=-3.15,P=0.003),平均住院时间短于对照组(t=-4.05,P<0.01),差异均有统计学意义。结论快速康复外科护理能够有效促进结直肠癌NOSES手术患者的术后恢复、改善焦虑抑郁状况,值得临床推广应用。Objective To explore the effects of enhancing recovery after surgery(ERAS)nursing on postoperative recovery and mental state among colorectal cancer after natural orifice specimen extraction surgery(NOSES).Methods Ninety patients were enrolled.All the patients received natural orifice specimen extraction surgery from May 2018 to March 2019 and were divided into two groups with the method of random number table,45 cases in each group.Observation group carried out ERAS nursing,while control group adopted routine nursing.To observe the differences in exhaust time,defecation time,hospitalization time,get out of bed time and the degree of anxiety and depression.Results At admission,there was no difference in the degree of anxiety(t=0.744,P=0.461)and depression(t=-1.879,P=0.066).After intervention,there were significant differences in the degree of anxiety(t=-5.85,P<0.01)and depression(t=-6.04,P<0.01),exhaust time(t=-2.32,P=0.025),defecation time(t=-2.48,P=0.017),time to get out of bed(t=-3.15,P=0.003)and the hospitalization time(t=-4.05,P<0.01).Conclusion ERAS nursing can effectively improve the postoperative recovery after the natural orifice specimen extraction surgery and alleviate the degree of anxiety and depression.

关 键 词：结直肠肿瘤 术后恢复 经自然腔道取标本手术 焦虑抑郁 快速康复外科护理 

分 类 号：R473.73[医药卫生—护理学]