快速康复外科理念在胃癌不同术式患者围术期护理中的应用  

Application of rapid rehabilitation surgery concept in perioperative nursing care of patients with gastric cancer undergoing different surgical procedures

作　　者：唐梦娟[1] 贾葵[1] 陆珍珍[1] 潘色杰[1] 苏妮[1] TANG Meng-juan;JIA Kui;LU Zhen-zhen;PAN Se-jie;SU Ni(The First Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region,530021,China)

机构地区：[1]广西医科大学第一附属医院胃肠腺体外科一区,广西南宁530021

出　　处：《蛇志》2020年第4期478-481,共4页Journal of Snake

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20201452)。

摘　　要：目的探讨快速康复外科理念在胃癌不同手术方式患者围手术期护理中的应用效果。方法回顾性分析2016年12月~2019年12月我院收治的352例胃癌患者的临床资料。按患者意愿选择手术方式并进行分组,其中A组采用传统围手术期护理行开腹手术者102例,B组采用FTS护理行开腹手术者92例,C组采用FTS护理行3D腹腔镜手术者106例,D组采用FTS护理行达芬奇机器人手术者52例。比较4组患者肛门排气时间、术后进食时间、术后第3天进食量、术后下床时间、术后住院天数、住院总费用、术后24 h内恶心与呕吐的发生率、术后不同时间疼痛评分情况。结果B、C、D组与A组相比,肛门排气时间、术后进食时间、术后下床活动时间提前,术后第3天进食量增加,术后住院天数缩短,术后24 h内恶心的发生率降低,术后不同时间的疼痛评分均降低,差异均有统计学意义(均P<0.05);而C、D组与B组相比,术后住院天数明显缩短,差异均有统计学意义(均P<0.05)。B、C组与A组相比,住院总费用降低,但D组住院总费用高于3组,组间比较差异均有统计学意义(均P<0.05)。结论快速康复外科对不同手术方式的患者均有促进术后康复、降低术后24 h内恶心发生率以及缓解术后疼痛的作用,值得临床推广应用。Objective To explore the effect of fast track surgery in perioperative nursing of gastric cancer patients Methods The clinical data of 352 patients with gastric cancer admitted to our department from December 2015 to May 2018 were retrospectively analyzed.Surgery was selected and grouped according to the patients’wishes.102 patients underwent laparotomy with traditional perioperative nursing in group A;92 patients underwent laparotomy with FTS nursing in group B,106 patients underwent 3D laparoscopic surgery with FTS nursing in group C,and 52 patients with Da Vinci robot surgery with FTS nursing in group D.Four groups were compared the anus exhaust time,postoperative eating time,postoperative day 3 food intake,postoperative bed time,postoperative hospitalization days,the total cost after operation,the incidence of postoperative nausea and vomiting within 24 h,different time of postoperative pain score.Results Group B,C,D group compared with group A,the anal exhaust time,postoperative eating ahead of time,postoperative bed time advanced,postoperative day 3 food intake increased,postoperative hospitalization days shorten,the incidence of nausea within 24 h after surgery decreased and the postoperative pain scores were lower;compared with group B,group C and group D had shorter hospitalization days after surgery;compared with group A,group B and group C reduced the total cost of hospitalization,but the total hospitalization expenses of group D were higher than those of the other three groups;all the differences was statistically significant(P<0.05 for each).Conclusion Fast track surgery nursing has the effect of promoting postoperative rehabilitation,reducing the incidence of nausea within 24 hours after surgery and alleviating postoperative pain for patients with different surgical methods,which is worthy of clinical application and promotion.

关 键 词：快速康复外科 胃癌 术式 围手术期 护理 

分 类 号：R735.2[医药卫生—肿瘤] R473.73[医药卫生—临床医学]