快速康复外科护理在口腔癌患者皮瓣修复围术期中的应用效果  

Application effect of the concept of fast-track surgery in perioperative nursing of oral cancer patients with flap repair

作　　者：黄媛媛[1] 王红[1] 李润婕 HUANG Yuanyuan;WANG Hong;LI Runjie(Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing,210029,China)

机构地区：[1]南京医科大学附属口腔医院,江苏省南京市210029

出　　处：《护理实践与研究》2022年第7期1062-1066,共5页Nursing Practice and Research

基　　金：江苏高校优势学科建设工程资助项目(编号:2018-87)。

摘　　要：目的探讨快速康复外科(FTS)理念在口腔癌皮瓣修复患者围术期护理中的临床应用效果。方法选取2019年1月—2020年12月南京医科大学附属口腔医院颌面外科接受皮瓣移植修复手术治疗的口腔癌患者作为研究对象,将2019年1—12月采取常规围术期管理的143例患者作为对照组,将2020年1—12月采取FTS管理的162例患者纳入观察组。对比两组患者恢复进程指标(拔管时间、首次进食时间、术后卧床时间、输液时间、住院时间),评估两组患者术后心理状态与术后疼痛程度,调查两组患者对于护理的满意度及术后并发症发生率与皮瓣成活率。结果采用FTS管理护理后,观察组患者术后引流拔管时间、首次进食时间、卧床时间、输液时间、住院时间均少于对照组,差异有统计学意义(P<0.05);观察组患者术后SAS、SDS、VAS得分均低于对照组,差异有统计学意义(P<0.05);观察组患者满意度调查各项目得分与总分均高于对照组,差异均有统计学意义(P<0.05);观察组皮瓣成活率高于对照组,肺感染、胃肠道反应、压力性损伤发生率低于对照组,差异均有统计学意义(P<0.05)。结论FTS理念应用于口腔癌皮瓣移植修复围术期中,能够提高皮瓣成活率,加快术后恢复进程,减轻术后疼痛程度,改善患者心理状态,降低术后并发症发生概率,提高患者满意度。Objective To explore the clinical effect of fast-track surgery(FTS)concept in perioperative nursing of oral cancer patients with flap repair.Methods A total of 143 oral cancer patients who received flap repair surgery in the department of maxillofacial surgery of Affiliated Stomatological Hospital of Nanjing Medical University from January 2019 to December 2020 were selected as the study subjects,143 patients who received routine perioperative management from January 2019 to December 2019 were selected as the control group,162 patients who underwent FTS management from January to December 2020 were enroued in the observation group.The recovery process indicators of patients in two groups were compared(extubation time,fi rst feeding time,postoperative bed time,infusion time and hospital stay),postoperative psychological state and postoperative pain degree of patients in the two groups were evaluated,and the nursing satisfaction,postoperative complication rate and skin fl ap survival rate of patients in the two groups were investigated.Results After FTS management nursing,postoperative drainage extubation time,fi rst feeding time,bed time,infusion time and hospital stay time in the observation group were all shorter than the control group,the dif ference was statistically significant(P<0.05).The scores of SAS,SDS and VAS in observation group were lower than the control group,the dif ferences were statistically significant(P<0.05).The scores and total scores of each item in patient’s satisfaction survey in the observation group were higher than the control group,the dif ference was statistically significant(P<0.05).The survival rate of the skin fl ap in the observation group was higher than the control group,the incidence of lung infection,gastrointestinal reaction and stress injury was lower than the control group,the dif fenence was statistically significant(P<0.05).Conclusion FTS concept applied in the perioperative repair of oral cancer flap transplantation could improve the survival rate of the flap,speed up

关 键 词：快速康复外科 口腔癌皮瓣修复 围术期 恢复进程 心理状态 疼痛程度 

分 类 号：R473.78[医药卫生—护理学]