医护一体化在肝癌行部分肝切除患者加速康复中的应用研究  

Study on the Application of Medical-nursing Integration in Accelerated Rehabilitation of Patients with Liver Cancer Undergoing Partial Hepatectomy

作　　者：尹秀芬[1] 罗革[1] 黄伶俐 孙甜 罗彩玉 YIN Xiufen;LUO Ge;HUANG Lingli;SUN Tian;LUO Caiyu(Affiliated Hospital of Guilin Medical College,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院,广西桂林541001 [2]广西肝脏损伤与修复分子医学重点实验室 [3]桂林医学院

出　　处：《中外医学研究》2020年第33期111-113,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z20190843);广西肝脏损伤与修复分子医学重点实验室经费开放课题资助项目(GXLIRMMKL-201914)。

摘　　要：目的:探讨医护一体化在肝癌行部分肝切除患者加速康复中应用效果。方法:采用历史对照抽样法,选择2017年10月-2018年9月在笔者所在医院肝胆外科行部分肝切除的原发性肝癌患者45例作为对照组;另选取2018年10月-2019年9月在笔者所在医院肝胆外科行部分肝切除的原发性肝癌患者48例作为观察组。对照组的患者采用常规护理模式,观察组采用医护一体化模式,并联合将ERAS理念贯穿在诊疗护理过程中进行干预。比较两组患者术后并发症(出血、肝功能衰竭、膈下感染、胆漏、胸腔积液等)、术后肠道功能恢复时间(肛门排气、排便时间)、下床活动时间及术后住院天数。结果:观察组术后肛门排气、排便时间、术后住院天数及开始下床活动时间均短于或少于对照组,差异均有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:医护一体化模式能促进加速康复外科理念的落实,从而促进肝癌行部分肝切除患者的康复,且不增加术后并发症的发生率。Objective:To explore the effect of integrated medical-nursing in accelerated rehabilitation of patients with liver cancer undergoing partial hepatectomy.Method:Using the historical control sampling method,forty-five patients with primary liver cancer underwent partial hepatectomy in the Department of Hepatobiliary Surgery of our hospital from October 2017 to September 2018 were selected as the control group.Another 48 patients with primary liver cancer underwent partial hepatectomy from October 2018 to September 2019 were selected as the observation group.The patients in the control group adopted the routine nursing mode,the observation group adopted the mode of integration of health care.And the concept of ERAS was combined to carry out intervention in the process of diagnosis,treatment and nursing.The postoperative complications(bleeding,liver failure,subphrenic infection,bile leakage,pleural effusion,etc.),the recovery time of intestinal function(anal exhaust,defecation time),the time of getting out of bed and the days of hospitalization were compared between the two groups.Result:The postoperative anal exhaust,defecation time,postoperative hospital stay and the time to get out of bed in the observation group were earlier or shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Integrated mode of health care can promote the implementation of the concept of rehabilitation surgery,so as to promote the rehabilitation of patients with liver cancer undergoing partial hepatectomy without increasing the incidence of postoperative complications.

关 键 词：加速康复 护理 医护一体化 肝癌 手术 

分 类 号：R473.6[医药卫生—护理学]