临床护理路径在腹腔镜胃癌根治术后早期肠内营养中的应用  

Application of Clinical Nursing Pathway in Early Enteral Nutrition after Laparoscopic Radical Gastrectomy for Gastric Cancer

作　　者：肖贵元 XIAO Guiyuan(Liaoyang Central Hospital,Liaoyang 111000,China)

机构地区：[1]辽阳市中心医院,辽宁辽阳111000

出　　处：《中国医药指南》2022年第11期121-124,共4页Guide of China Medicine

摘　　要：目的探讨对腹腔镜胃癌根治术患者采用临床护理路径配合完成早期肠内营养干预可行性,旨在提升临床治疗的成效,强化公共医疗的服务能力,减少胃癌患者的疼痛感与不适感。方法本次研究过程中,采取分组对比的方式,设立不同的组别,通过横向对比的方式,掌握不同治疗方案的成效与水平。将我院2018年5月至2020年4月收治的86例腹腔镜胃癌根治术患者按数字奇偶法分组;护理组(43例):采用围手术期常规护理+临床护理路径方式配合完成早期肠内营养干预;常规组(43例):采用围手术期常规护理方式配合完成早期肠内营养干预;就组间机体免疫功能变化以及胃肠功能指标展开对比。结果护理前,护理组腹腔镜胃癌根治术患者CD_(8)^(+)(32.77±8.05)、CD_(4)^(+)(30.39±7.16)、CD_(3)^(+)(63.59±8.36)以及CD_(4)^(+)/CD_(8)^(+)(1.05±0.52)同常规组(33.51±7.91)、(30.17±8.13)、(62.95±8.27)以及(1.04±0.53)比较差异无统计学意义(P>0.05);护理后,护理组CD_(8)^(+)(37.91±8.12)、CD_(4)^(+)(38.73±6.51)、CD_(3)^(+)(68.81±8.89)以及CD_(4)^(+)/CD_(8)^(+)(1.42±0.23)均高于常规组(33.89±7.57)、(32.36±6.76)、(57.17±7.85)以及(1.22±0.53)明显(P<0.05);护理组腹腔镜胃癌根治术患者开始进食时间(7.67±2.20)d、肠鸣音恢复时间(36.21±13.51)h以及肛门排气时间(44.41±15.62)h均短于常规组(11.91±2.49)d、(44.81±16.92)d及(56.52±17.42)d明显(P<0.05)。结论临床护理路径方式配合运用于早期肠内营养支持,可使得腹腔镜胃癌根治术机体免疫功能变化获得显著改善,同时促进其胃肠功能指标改善,使得患者术后恢复获得加快,最终充分实现腹腔镜胃癌根治术患者有效预后。Objective To explore the feasibility of early enteral nutrition intervention for patients undergoing laparoscopic radical gastrectomy with clinical nursing path,in order to improve the effectiveness of clinical treatment,strengthen the service capacity of public medical treatment,and reduce the pain and discomfort of patients with gastric cancer.Methods In this study,different groups were set up by grouping and comparison,and the effectiveness and level of different treatment programs were mastered through horizontal comparison.A total of 86 patients with laparoscopic radical gastrectomy in our hospital from May 2018 to April 2020 were divided into two groups by odd-even method.Nursing group(43 cases):early enteral nutrition intervention was completed by perioperative routine nursing+clinical nursing path;routine group(43 cases):early enteral nutrition intervention was completed by routine perioperative nursing.The changes of immune function and gastrointestinal function indexes were compared between the groups.Results Care before,CD_(8)^(+)(32.77±8.05),CD_(4)^(+)(30.39±7.16),CD_(3)^(+)(63.59±8.36)and CD_(4)^(+)/CD_(8)^(+)(1.05±0.52)in patients with laparoscopic radical gastrectomy were compared with those in the conventional group(33.51±7.91),(30.17±8.13),(62.95±8.27)and(1.04±0.53)had no significant difference(P>0.05).After nursing,CD_(8)^(+)(37.91±8.12),CD_(4)^(+)(38.73±6.51),CD_(3)^(+)(68.81±8.89)and CD_(4)^(+)/CD_(8)^(+)(1.42±0.23)in nursing group were higher than those in conventional group(33.89±7.57),(32.36±6.76),(57.17±7.85)and(1.22±0.53)significantly(P<0.05).In the nursing group,the time to start eating(7.67±2.20)days,bowel sound recovery time(36.21±13.51)hours and anal exhaust time(44.41±15.62)hours were shorter than those in the conventional group(11.91±2.49)days,(44.81±16.92)days and(56.52±17.42)days significantly(P<0.05).Conclusion clinical nursing path way used in early enteral nutrition support,can make the body's immune function laparoscopic gastric cancer radical change get

关 键 词：临床护理路径 腹腔镜胃癌根治术 机体免疫功能变化 胃肠功能指标 

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