快速康复外科理念对胰腺癌手术患者围术期应激反应及术后康复进程的影响  

Effect of the concept of the enhanced rehabilitation after surgery on perioperative stress response and postoperative rehabilitation of pancreatic cancer patients

作　　者：李萍 马菊花 金明雪 孟利 LI Ping;MA Juhua;JIN Mingxue(Department of Hepatobiliary and Pancreatic Hernia Surgery,Qinghai Red Cross Hospital,Qinghai,Xining 810000,China)

机构地区：[1]青海省红十字医院肝胆胰疝外科,西宁市810000

出　　处：《河北医药》2024年第24期3821-3824,共4页Hebei Medical Journal

摘　　要：目的分析快速康复外科理念应用于胰腺癌手术患者中对其围术期应激反应及术后康复进程的影响。方法选取2020年1月至2023年12月接受诊疗的胰腺癌手术患者80例作对象,以电脑随机数表法为依据分组,对照组40例的护理方法为常规护理,观察组40例通过快速康复外科理念予以护理,比较2组患者的围术期应激反应、预期性悲伤水平、术后康复进程及生命质量。结果术后3 d,2组患者的皮质醇(Cor)、促肾上腺皮质激素(ACTH)、前列腺素E2(PGE2)及神经肽Y(NPY)水平均高于术前,组间比较,观察组较低(P<0.05);护理后,观察组的《癌症患者预期性悲伤量表》分数是(30.25±4.17)分,对照组是(35.60±4.22)分,组间比较,观察组更低(P<0.05);2组患者术后的输液量、首次排气、首次进食、首次饮水、首次排便、首次下床及住院的时间进行比较,观察组更低/短(P<0.05);观察组的《中文版癌症患者生命质量通用量表(FACT-G)》分数是(78.95±17.34)分,对照组是(67.81±17.49)分,组间比较,观察组更高(P<0.05)。结论快速康复外科理念应用于胰腺癌手术患者中可取得显著效果,不仅能够缓解围术期应激反应,改善其预期性悲伤水平,而且还能缩短患者术后康复进程,促进其生命质量升高。Objective To analyze the effects of the concept of the enhanced rehabilitation after surgery(ERAS)on perioperative stress response and postoperative rehabilitation in pancreatic cancer patients.Methods A total of 80 surgically treated pancreatic cancer patients from January 2020 to December 2023 were selected.They were randomly assigned into the control group(n=40,routine nursing care)and observation group(n=40,ERAS-based nursing care)based on the computer random number table method.The perioperative stress response,preparatory grief,postoperative rehabilitation process and quality of life were compared between the two groups.Results Three days after surgery,cortisol(Cor),adrenocorticotropic hormone(ACTH),prostaglandin E2(PGE2),and neuropeptide Y(NPY)of the both groups were significantly higher than the preoperative values,which were significantly lower in the observation group than the control group(P<0.05).After nursing,the Preparatory Grief in Advanced Cancer(PGAC)score in the observation group was significantly lower than that of the control group[30.25±4.17]points vs[35.60±4.22]points,(P<0.05).The postoperative infusion volume,first exhaust time,first eating time,first drinking time,first defecation time,first off-bed activity time and length of stay were significantly less in the observation group than those of control group(P<0.05).In the observation group,the Functional Assessment of Cancer Therapy General(FACT-G)score was significantly higher than that of the control group[78.95±17.34]points vs[67.81±17.49]points,(P<0.05).Conclusion The application of ERAS-based nursing care for pancreatic cancer patients can achieve remarkable results,which alleviates perioperative stress response and preparatory grief,shortens the postoperative rehabilitation process and promotes the improvement of their quality of life.

关 键 词：快速康复外科理念 胰腺癌手术 应激反应 康复进程 生命质量 

分 类 号：R735.9[医药卫生—肿瘤]