加速康复外科理念在肝癌患者术后护理中的应用研究

发布时间：2018-01-11 16:28

本文关键词：加速康复外科理念在肝癌患者术后护理中的应用研究　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨加速康复外科技术在原发性肝细胞癌患者部分肝切除术后护理中应用的有效性及安全性。方法:选取新疆某三级甲等肿瘤专科医院肝胆胰外科2015年7月至2016年12月共130例原发性肝癌行肝切除手术治疗的患者为研究对象,随机分为加速康复外科组(ERAS组,n=65)、对照组(C组,n=65),ERAS组采用加速康复外科理念进行肝癌手术患者围手术期护理,C组采用常规护理方法护理。比较两组患者术后24h、48h、72h及1w的护理结局及指标评分、术后下床活动时间、肠道通气时间、术后住院时间、住院费用、术后48h疼痛评分及患者护理满意度。结果:1.基线结果:两组患者在性别、年龄、诊断、术前肝功能储备、手术方式等方面差异无统计学差异(P0.05),具有均衡可比性;2.术后24h ERAS组的护理结局焦虑水平、疼痛控制、睡眠、营养状态:食物和液体的摄入、知识:饮食、更换体位:主动、术后康复状态评分与C组比较,差异有统计学意义(P0.05);术后48h ERAS组的焦虑水平、疼痛控制、睡眠、营养状态:食物和液体的摄入、更换体位:主动、术后康复状态评分与C组比较,差异有统计学意义(P0.05);术后72h ERAS组的护理结局焦虑水平、疼痛控制、睡眠、术后康复状态各指标评分与C组比较,差异均有统计学意义(P0.05);术后1w ERAS组术后康复状态评分与C组比较差异有统计学意义(P0.05);3.临床指标结果:干预后两组患者术后下床活动时间、肠道通气时间、术后住院天数、住院费用、术后48h疼痛评分及患者满意度比较均有统计学意义(P0.05)。结论:加速康复外科技术在肝癌患者术后护理中的应用是安全、有效的,对患者术后焦虑水平、疼痛控制、睡眠等多个结局有积极的影响,可减少患者术后住院时间与住院费用,加快肠道恢复,促进早期恢复经口饮食与下床活动,提高患者对护理工作满意度。
[Abstract]:Objective: To investigate the safety and efficacy of accelerated rehabilitation surgery technique applied in nursing of patients with hepatocellular carcinoma after partial hepatectomy. Methods: in Xinjiang a three level of first-class hospital of hepatobiliary surgery from July 2015 to December 2016 a total of 130 cases of patients with primary surgical treatment for hepatic resection for hepatocellular carcinoma as the research object and randomly divided into accelerated rehabilitation surgery group (group ERAS, n=65), control group (C group, n=65 group, ERAS) by using the concept of accelerated rehabilitation surgery for liver cancer patients during operation period nursing, C group received the routine nursing care. The two groups were compared after treatment of 24h, 48h, and 72h and nursing outcome index the 1W score, the time of getting out of bed after operation, intestinal ventilation time, postoperative hospitalization time, cost of hospitalization, postoperative 48h pain score and nursing satisfaction of patients. Results: 1. baseline results: two groups in gender, age, diagnosis, preoperative liver function reserve The preparation, no statistically significant difference between the operation mode (P0.05), with a comparable level of anxiety; nursing outcomes, 24h ERAS group of 2. postoperative pain control, sleep, nutrition status: intake, food and liquid knowledge: diet, change posture: active, postoperative rehabilitation status score and C group comparison, the difference was statistically significant (P0.05); the level of anxiety, 48h ERAS group of postoperative pain control, sleep, food intake, and nutritional status: liquid change posture: active state, group C score and postoperative rehabilitation, the difference was statistically significant (P0.05); the anxiety level of nursing outcome, 72h ERAS group of postoperative pain control, sleep, compare the index status score and C group rehabilitation after operation, the differences were statistically significant (P0.05); 1W ERAS postoperative rehabilitation status score and C group had significant difference (P0.05); the 3. clinical indicators. Results: after the intervention of two groups of patients Get out of bed time, intestinal ventilation time, postoperative hospital stay, cost of hospitalization, postoperative 48h pain score and patient satisfaction were statistically significant (P0.05). Conclusion: the application of accelerated rehabilitation surgery in nursing in postoperative patients with hepatocellular carcinoma is safe, effective, for patients with postoperative anxiety, pain control, have the positive effects of sleep as a result, can reduce the postoperative hospitalization time and hospitalization costs, accelerate intestinal recovery, promote early recovery after eating and ambulation, improve patient satisfaction with nursing work.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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