降阶梯思维模式护理对肝癌手术患者的影响  

Eff ects of step-down thinking mode nursing on liver cancer operation patients

作　　者：顾冰冰 冯秋琪 季亦楠 周熠雯 周曹倜 GU Bingbing;FENG Qiuqi;JI Yinan;ZHOU Yiwen;ZHOU Caoti(The Third People's Hospital of Nantong,Nantong 22600,China)

机构地区：[1]江苏省南通市第三人民医院十一病区肝胆甲乳外科,江苏省南通市226000

出　　处：《护理实践与研究》2025年第4期613-619,共7页Nursing Practice and Research

基　　金：南通市卫生健康委员会科研课题(编号:MSZ2023051)。

摘　　要：目的探讨降阶梯思维模式护理对肝癌围手术期患者肝功能、术后恢复情况与生活质量的影响。方法选取2022年6月—2023年6月医院行手术治疗的100例肝癌患者为研究对象,按组间基本特征具有可比性的原则分为观察组和对照组,每组50例。对照组患者采用常规护理,观察组患者在对照组的基础上应用降阶梯思维模式护理。比较两组肝癌手术患者并发症(感染、腹水、肝性脑病)发生率、干预前后肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBiL)]水平、生活质量改善情况及术后恢复情况(术后肛门排气时间、排便时间、住院时间)。结果护理干预前,两组肝癌患者ALT、AST、TbiL水平、生活质量评分的比较,差异均无统计学意义(P>0.05);护理干预后,观察组患者丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素水平低于对照组,差异均有统计学意义(P<0.05)。生活质量评分高于对照组,差异有统计学意义(P<0.05)。并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后肛门排气时间、排便时间、住院时间短于对照组,差异均有统计学意义(P<0.05)。结论降阶梯思维模式应用于肝癌围手术期患者,能改善肝癌术后患者肝功能水平,缩短患者术后肛门排气时间、排便时间、住院时间,减少并发症发生率,提升患者生活质量。Objective To explore the effects of step-down thinking mode nursing on liver function,postoperative recovery and quality of life on perioperative patients with hepatocellular carcinoma.Methods To select 100 cases of hepatocellular carcinoma patients who underwent surgical treatment in the hospital from June 2022 to June 2023 as research subjects,they were divided into an observation group and a control group according to the principle of comparability of basic characteristics between groups,with 50 cases in each group.The patients in the control group were treated with conventional nursing,the patients in the observation group were treated with step-down thinking mode nursing on the basis of the control group.To compared the incidence of complications(infection,ascites,hepatic encephalopathy),liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBiL)]levels,quality of life scores,and postoperative recovery(postoperative anal defecation time,defecation time,and hospital stay)between the two groups of patients who were operated for hepatocellular carcinoma.Results Before nursing intervention,there was no statistically signifi cant diff erence in the comparison of ALT,AST,TbiL levels and quality of life scores between the two groups of hepatocellular carcinoma patients(P>0.05).After nursing intervention,alanine aminotransferase,aspartate aminotransferase,and total bilirubin levels of the patients in the observation group were lower than those of the control group,the diff erences were all statistically signifi cant(P<0.05).The quality of life score was higher than that of the control group,the diff erence was statistically signifi cant(P<0.05).The complication rate was lower than that of the control group,the diff erence was statistically signifi cant(P<0.05).Postoperative anal defecation time,defecation time and hospitalisation time were shorter than that of the control group,and the diff erences were statistically signifi cant(P<0.05).Conclusion The step-down thinking mode a

关 键 词：降阶梯思维模式 护理 手术 肝癌 肝功能 生活质量 

分 类 号：R473.73[医药卫生—护理学]