基于加速康复外科理念的中西医结合护理在食管癌患者围术期的应用  

The effect of combined Chinese and western medicine nursing based on the concept of enhanced recovery after surgery on patients with esophageal cancer in perioperative period

作　　者：冯娟[1] 宋凤云[2] 邵玉会[1] 柏萍[1] 姜秀丽[1] 张艳[3] 阴涛 肖文明[1] 孟潘庆[1] Feng Juan;Song Fengyun;Shao Yuhui;Bai Ping;Jiang Xiuli;Zhang Yan;Yin Tao;Xiao Wenming;Meng Panqing(Department of Surgery Oncology,Central Hospital of Tai'an,271000,China;Department of Physical Examination,Central Hospital of Tai'an,271000,China;Department of Thoracic Surgery,Central Hospital of Tai'an,271000,China;Department of Rehabilitation Medicine,Central Hospital of Tai'an,271000,China)

机构地区：[1]泰安市中心医院肿瘤外科,271000 [2]泰安市中心医院体检科,271000 [3]泰安市中心医院胸外科,271000 [4]泰安市中心医院康复医学科,271000

出　　处：《国际护理学杂志》2022年第7期1246-1250,共5页international journal of nursing

基　　金：泰安市科技局2017年科学技术发展引导计划项目(No.2017NS0214)。

摘　　要：目的探讨基于加速康复外科理念(ERAS)的中西医结合护理在食管癌患者围术期的应用效果。方法将2016年12月至2019年11月泰安市中心医院符合纳入标准的食管癌住院微创手术患者183例随机分为ERAS护理组、传统护理组、中西医结合+ERAS护理组三组,每组61例。传统护理组给予常规的护理措施,ERAS护理组采用ERAS护理方法,中西医结合+ERAS组在ERAS组的基础上加上中西医结合护理。三组患者均检测血谷丙转氨酶、白蛋白、总胆红素、术后住院天数、术后首次肛门排气时间、拔除胃管时间及术后进食固体食物时间等。结果术后第1天三组疼痛比较无差异性,但是在术后第3、7天三组疼痛比较,差异均有统计学意义(均P<0.0001),两两比较结果看出,ERAS组的疼痛比传统组降低,差异有统计学意义(P<0.0001),中西医结合+ERAS组比ERAS组降低更显著,差异有统计学意义(P<0.0001)。与传统护理组相比,ERAS组肛门首次排气时间、拔胃管时间和术后进固体食物时间结果均优于传统护理组,差异有统计学意义(P<0.05)。与ERAS组相比,中西医结合+ERAS组的拔胃管时间、术后进固体食物时间和术后住院天数结果的差异均有统计学意义(P<0.05)。而肛门首次排气时间结果的差异均无统计学意义(P>0.05)。结论中西医结合+ERAS的护理更加能够明显提高食管癌外科围术期的早期康复训练效果,促进患者康复。Objective To observe the effect of combined Chinese and western medicine nursing based on the concept of Enhanced Recovery After Surgery(ERAS)on the perioperative patients with esophageal cancer.Methods A total of 183 inpatients with minimally invasive surgery for esophageal cancer who met the inclusion criteria from December 2016 to November 2019 were randomly divided into ERAS care group,traditional nursing group,integrated Chinese and western medicine+ERAS care group,with 61 cases in each group.The traditional nursing group was given routine nursing measures.The ERAS nursing group adopted ERAS nursing method.The combination of Chinese and western medicine+ERAS group was based on the ERAS group,plus the combination of Chinese and western medicine.All patients in the three groups were tested for glutamic pyruvic transaminase,albumin,total bilirubin,length of stay after operation,time of first anal exhaust after operation,time of gastric tube extubation,time of solid eating after operation,etc.Results There was no difference among the three groups on the first day after operation,but on the third and seventh day after operation,the difference was statistically significant(P<0.0001).From the comparison results of the two nursing groups,the pain of ERAS group was lower than that of the traditional nursing group,with statistical significance(P<0.0001).The combination of traditional Chinese and western medicine+ERAS group was significantly lower than that of ERAS group,and the difference was statistically significant(P<0.0001).Compared with the traditional nursing group,the results of the first time of anal exhaust,the time of gastric tube extubation and the time of solid food intake in ERAS group were better than those in the traditional nursing group,and the difference was statistically significant(P<0.05).Compared with ERAS group,there were significant differences in the time of extubation of gastric tube,the time of feeding solid food after operation and the number of days in hospital after operation(P<0.05).Ther

关 键 词：食管癌 加速康复外科 中西医结合 护理 围术期 

分 类 号：R473.73[医药卫生—护理学]