中医适宜技术对胃癌患者围手术期快速康复的效果评价  

The effect of TCM appropriate technology on rapid rehabilitation of perioperative gastric cancer patients

作　　者：张红梅[1] 陈露璐 李金娥[1] 卢清秀[1] 白小龙[1] 张芙蓉[1] 杨海侠[1] ZHANG Hongmei;CHEN Lulu;LI Jin’e;LU Qingxiu;BAI Xiaolong;ZHANG Furong;YANG Haixia

机构地区：[1]西安交通大学第二附属医院,陕西西安710004

出　　处：《中医临床研究》2022年第27期107-110,共4页Clinical Journal Of Chinese Medicine

基　　金：陕西省重点研发计划(2020SF-278)。

摘　　要：目的:探讨中医适宜技术对胃癌患者围手术期生理、心理快速康复的作用。方法:104例胃癌择期手术患者被随机分为观察组和对照组各52例,对照组采用快速康复护理,观察组在快速康复护理的基础上联合应用中医适宜技术干预。比较两组患者术后胃肠功能恢复、疼痛评分、围手术期焦虑抑郁评分、术后炎症介质变化并记录消化道不良反应。结果:观察组术后首次排气时间、腹胀消除时间、首次排便时间、经口进食时间均短于对照组,差异有统计学意义(P<0.05)。两组患者术后1 d、术后3 d、术后7 d视觉模拟评分法(Visual Analogue Scale,VAS)评分值依次降低,且观察组低于对照组(P<0.05)。出院前两组患者汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分低于手术前,观察组较对照组下降明显(P<0.05)。两组患者术后5 d炎症介质血清肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、C反应蛋白(C-Reactive Protein,CRP)、白细胞介素-1β(Interleukin-1β,IL-1β)水平均低于术后2 d,且观察组低于对照组(P<0.05)。住院期间,观察组总不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:中医适宜技术联合快速康复护理能明显改善胃癌患者围手术期后胃肠功能障碍,减轻疼痛,改善患者的焦虑抑郁情绪,减轻急性炎症反应,减少术后并发症的发生,加速患者康复,值得临床推广应用。Objective:To explore the effects of TCM appropriate technology on rapid physical and psychological recovery of perioperative gastric cancer patients.Methods:A total of 104 cases were randomly divided into the observation group and the control group,with 52 cases in each group.The control group received rapid rehabilitation nursing,and the observation group was given TCM appropriate technology on the basis of rapid rehabilitation nursing.Results:The time of first postoperative exhaust,abdominal distension elimination,first defecation and oral feeding time in the observation group was all shorter than those in the control group,and the difference was statistically significant(P<0.05).The VAS scores in the two groups were decreased sequentially on the 1st,3 rd,and 7th days after surgery,and in the observation group were lower than the control group(P<0.05).Before discharge,the scores of HAMA and HAMD in the two groups were lower than those before operation,and in the observation group were significantly lower than the control group(P<0.05).The serum levels of inflammatory mediators such as TNF-α,CRP and IL-1βin the two groups on 5th day after surgery were lower than 2 rd day after surgery,and in the observation group were lower than the control group(P<0.05).During hospitalization,the incidence of total adverse reactions in the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Conclusion:The combination of TCM appropriate technology and rapid rehabilitation nursing can significantly ameliorate gastrointestinal dysfunction in perioperative gastric cancer patients,relieve pain,ameliorate anxiety and depression emotions,reduce acute inflammatory reaction,reduce postoperative complications,and promote recovery.It is worthy of clinical promotion and application.

关 键 词：中医适宜技术 胃癌 焦虑抑郁状态 炎症介质 快速康复 

分 类 号：R735.2[医药卫生—肿瘤]