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基于加速康复外科理念的护理干预在晚期直肠癌减瘤术联合腹腔灌注化疗患者中的应用效果

Application effect of nursing intervention based on concept of enhanced recovery after surgery in patients with advanced rectal cancer after cytoreductive surgery combined with intraperitoneal perfusion chemotherapy

    摘要
  • 摘要:
    目的 观察基于加速康复外科(ERAS)理念的护理干预在晚期直肠癌减瘤术联合腹腔灌注化疗患者中的应用效果。
    方法 选取直肠癌腹腔灌注化疗患者124例为研究对象，随机分为观察组(n=62)和对照组(n=62)。对照组采用常规护理干预，观察组在对照组基础上采用基于ERAS理念的护理干预。比较2组患者视觉模拟评分法(VAS)评分。比较2组干预前后的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分以及生活质量核心量表(QOL-C30)评分。比较2组不良反应发生情况和护理满意度。
    结果 第2、3次化疗时，观察组的VAS评分低于对照组，差异有统计学意义(P<0.05)。干预后, 2组SAS评分、SDS评分低于干预前，且观察组低于对照组，差异有统计学意义(P<0.05)。干预后, 2组QOL-C30的躯体功能、角色功能、情绪功能、认知功能、社会功能共5个维度评分高于干预前，且观察组高于对照组，差异有统计学意义(P<0.05); 2组QOL-C30的症状评分低于干预前，且观察组低于对照组，差异有统计学意义(P<0.05)。干预后，观察组不良反应发生率为56.45%, 低于对照组的77.42%, 差异有统计学意义(P<0.05)。干预后，观察组护理满意度评分高于对照组，差异有统计学意义(P<0.05)。
    结论 基于ERAS理念的护理干预可有效缓解晚期直肠癌减瘤术联合腹腔灌注化疗患者的疼痛感、不良情绪，降低不良反应发生率，提高生活质量，且护理满意度高。

     

    Abstract:
    Objective To observe the effect of nursing intervention based on concept of enhanced recovery after surgery (ERAS) in patients with advanced rectal cancer after cytoreductive surgery combined with intraperitoneal perfusion chemotherapy.
    Methods A total of 124 patients with intraperitoneal chemotherapy for rectal cancer were selected as study subjects, and randomly divided into observation group (n=62) and control group (n=62). The control group was treated with routine nursing intervention, and the observation group was treated with nursing intervention based on ERAS concept. Visual Analogue Scale (VAS) scores were compared between the two groups. The scores of Self Rating Anxiety Scale (SAS), Self Rating Depression Scale (SDS) and Quality of Life Questionary-Core 30 (QOL-C30) before and after intervention were compared between the two groups. The occurrence of adverse reactions and nursing satisfaction were compared between the two groups.
    Results The VAS score of the observation group was significantly lower than that of the control group at the 2nd and 3rd chemotherapy (P<0.05). After intervention, SAS score and SDS score in two groups were significantly lower than before intervention, and the observation group was significantly lower than the control group (P<0.05). After intervention, the QOL-C30 scores of body function, role function, emotional function, cognitive function and social function in two groups were significantly higher than before intervention, and the observation group was significantly higher than the control group (P<0.05); symptom score of QOL-C30 in two groups was significantly lower than before intervention, and the observation group was significantly lower than the control group (P<0.05). After intervention, the incidence of adverse reactions in the observation group was 56.45%, which was significantly lower than 77.42% in the control group (P<0.05). After intervention, the nursing satisfaction score of the observation group was significantly higher than that of the control group (P<0.05).
    Conclusion Nursing intervention based on ERAS concept can effectively relieve pain and adverse emotions in patients with advanced rectal cancer undergoing cytoreductive surgery combined with intraperitoneal perfusion chemotherapy, reduce the incidence of adverse reactions, and improve quality of life, with high nursing satisfaction.

     

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