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基于快速康复外科理念的肝癌患者术后护理

Nursing for patients with liver cancer based on concept of fast track surgery

    摘要
  • 摘要:
      目的  分析基于快速康复外科（FTS）理念的护理模式在肝癌切除术中的应用价值。
      方法  将108例肝癌切除术患者随机分为对照组和观察组，每组54例。对照组接受常规干预，观察组接受基于FTS理念的护理干预模式。观察2组术中及术后情况、并发症发生情况、护理满意度。比较2组术前、术后3 d的血清学指标。
      结果  2组术中输血量、出血量、肝门阻断时间及手术时间差异无统计学意义（P>0.05）。观察组肛门排气时间、术后下床活动时间、排便时间、腹腔引流管拔除时间、进食时间、住院时间短于对照组，差异有统计学意义（P < 0.05）。术后3 d，2组血清前蛋白水平较术前升高，且观察组高于对照组，血清丙氨酸氨基转移酶（ALT）、C反应蛋白水平较术前降低，且观察组低于对照组，差异均有统计学意义（P < 0.05）。观察组肝功能损害发生率为18.52%，低于对照组的37.04%，差异有统计学意义（P < 0.05）。出院时，观察组总满意度为96.30%，高于对照组的74.07%，差异有统计学意义（P < 0.05）。
      结论  基于FTS理念的护理干预模式可促进肝癌切除术患者ALT恢复正常，控制机体炎症反应，降低肝功能损害发生风险，缩短患者术后康复进程，提高护理满意度。

     

    Abstract:
      Objective  To analyze the application value of nursing model in the treatment of patients with hepatic carcinectomy based on concept of fast track surgery (FTS).
      Methods  A total of 108 patients with hepatic carcinectomy were randomly divided into control group (n=54) and observation group (n=54). The control group was given routine intervention, and the observation group was given nursing intervention model based on FTS concept. The intraoperative and postoperative conditions, complications and nursing satisfaction degree of the two groups were observed. The serological indexes before operation and 3 days after operation were compared between the two groups.
      Results  There were no significant differences in the amount of intraoperative blood transfusion, blood loss, block time of porta hepatis and operation time between the two groups (P>0.05). The time to anal exhaustion, postoperative time to bed-off activity, time to defecation, extubation time of abdominal drainage, time to meal and hospitalization time in the observation group were significantly shorter than those in the control group (P < 0.05). Three days after operation, the level of serum pre-albumin increased significantly in both groups, and the level of serum pre-albumin in the observation group was significantly higher than the control group, while the levels of serum alanine aminotransferase (ALT) and C reactive protein decreased significantly in both groups, and the levels of ALT and C reactive protein were significantly lower than the control group (P < 0.05). The incidence of liver function damage in the observation group was 18.52%, which was significantly lower than 37.04% in the control group (P < 0.05). At discharge, the total satisfaction degree of the observation group was 96.30%, which was higher than 74.07% of the control group (P < 0.05).
      Conclusion  Nursing intervention model based on FTS concept can promote ALT recovery in patients with hepatic carcinectomy, control the body inflammatory reactions, reduce the risk of liver function damage, shorten the recovery process after operation, and increase nursing satisfaction degree.

     

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