以赋能理论为框架的多维护理对腹腔镜肝癌肝切除术患者术后应激反应及恢复的影响  

Effects of multi-dimensional nursing based on empowerment theory on postoperative stress response and recovery in patients undergoing laparoscopic hepatectomy

作　　者：宋婷婷[1] 才次克 谷申森 SONG Ting-ting;CAI Ci-ke;GU Shen-sen(Department of Laparoscopic Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院肝脏腹腔镜外科,乌鲁木齐830054

出　　处：《中国肿瘤临床与康复》2020年第8期977-981,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨以赋能理论为框架的多维护理对腹腔镜肝癌肝切除术患者术后应激反应及恢复的影响。方法选取2017年8月至2019年8月间新疆医科大学第一附属医院收治的行腹腔镜肝切除术的80例肝癌患者,采用随机数字表法分为研究组和对照组,每组40例。对照组患者采用基础护理干预,研究组患者在对照组基础上采用赋能理论为框架的多维护理,比较两组患者术后应激反应(Cor、白细胞和CRP)及恢复情况。结果研究组患者术中出血量、术后通气时间和住院时间均低于对照组,差异均有统计学意义(P <0.05);手术时间及术后并发症均低于对照组,但差异无统计学意义(P> 0.05)。术后,两组患者VAS评分时点和组间差异均有统计学意义(均P <0.05)。研究组患者术后6h、1d、3d和5d的VAS评分均低于对照组,差异均有统计学意义(均P <0.05)。两组患者Cor组间和时点与组别交互效应差异均有统计学意义(均P <0.05),CRP和白细胞的时点、组间及时点与组别的交互效应差异均有统计学意义(均P <0.05)。研究组患者术后1d、3d和5d的Cor、CRP和白细胞均低于对照组,差异均有统计学意义(均P <0.05)。结论以赋能理论为框架的多维护理可有效减少围手术期肝癌患者的应激反应,改善肝功能,对术后康复有积极作用。Objective To explore the effects of multi-dimensional nursing based on the theory of empowerment on the postoperative stress response and recovery in patients undergoing laparoscopic hepatectomy for liver cancer. Methods Eighty patients with liver cancer who underwent laparoscopic hepatectomy at The First Affiliated Hospital of Xinjiang Medical University from August 2017 to August 2019 were selected as the study subjects. They were divided into a study group and a control group with 40 patients each using the random number table. Patients in the study group received multi-dimensional nursing with the framework of empowerment theory and patients in the control group received basic nursing intervention. The effects of different nursing modes on stress response( Cor,leukocyte and C-reactive protein) and recovery were compared between the two groups. Results The amount of intraoperative blood loss,postoperative ventilation and length of stay were lower in the study group than in the control group( all P < 0. 05). The duration of operation and postoperative complications were lower in the study group than in the control group( P > 0. 05). The difference in postoperative visual analogue scale( VAS) scores between the two groups at different time points was statistically significant( all P < 0. 05). The VAS scores at 6 h,1,3 and 5 d after surgery were lower in the study group than in the control group( all P < 0. 05). The difference in the levels of Cor between the two groups at different time points was statistically significant( all P < 0. 05). The difference in the levels of C-reactive protein and leukocyte was statistically significant between the two groups at different time points( all P < 0. 05). Levels of Cor,CRP and leukocyte were lower in the study group than in the control group on at 1,3 and 5 d after the surgery( all P < 0. 05). Conclusion Multi-dimensional nursing based on the theory of empowerment can effectively reduce perioperative stress response,improve liver function,and have a positive effect on po

关 键 词：腹腔镜肝切除术 肝肿瘤 赋能理论 多维护理 应激反应 

分 类 号：R735.7[医药卫生—肿瘤]