快速康复路径在原发性肝癌患者围手术期的应用

任春霞; 李伦兰; 丁萍; 王丽; 汪红霞; 吴乐; 范引光

doi:10.16462/j.cnki.zhjbkz.2016.06.015

快速康复路径在原发性肝癌患者围手术期的应用

doi: 10.16462/j.cnki.zhjbkz.2016.06.015

任春霞^1,2,
李伦兰³,
丁萍³,
王丽¹,
汪红霞¹,
吴乐¹,
范引光^2, ,

1. 安徽医科大学第一附属医院肝胆胰外科一病区, 安徽合肥 230022;
2. 安徽医科大学公共卫生学院流行病与卫生统计学系, 安徽合肥 230032;
3. 安徽医科大学第一附属医院护理部, 安徽合肥 230022

基金项目:

安徽省自然科学基金项目（1308085MHl51）；安徽医科大学第一附属医院新技术新项目（2013年）

详细信息

作者简介:
任春霞(1981-),女,安徽合肥人,主管护师,在读博士研究生。主要研究方向:临床护理。

中图分类号: R735.7;R493.3
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- 被引次数: 0
出版历程
- 收稿日期: 2016-01-18
- 修回日期: 2016-03-20

Application of fast-track pathway in perioperative patients with primary hepatic carcinoma

1. Ward One of Hepatopancreatobiliary Surgery Department, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China;
2. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China;
3. Department of Nursing, the Fist Affiliated Hospital of Anhui Medical University, Hefei 230022, China

摘要

摘要: 目的探讨基于快速康复外科理念的临床护理路径在原发性肝癌患者围手术期的应用效果。方法将87例原发性肝癌患者按入院时间先后分为对照组（45例）和干预组（42例），对照组接受常规肝癌围手术期护理，干预组采用快速康复护理路径标准化管理。观察比较两组患者围手术期焦虑自评量表（self-rating anxiety scales,SAS）得分、疼痛评分、术后不适与并发症发生率、术后住院时间、住院费用及再入院率的差异。结果干预组有39例和对照组43例患者完成本研究。干预组SAS得分和疼痛评分低于对照组，差异均有统计学意义（均有P<0.05）；两组术后不适和大部分并发症发生率、住院费用及再入院率比较差异均无统计学意义（均有P>0.05），而干预组肺部感染率低于对照组、术后住院时间短于对照组，差异均有统计学意义（均有P<0.05）。结论快速康复护理路径标准化管理有助于减轻肝癌患者手术应激和焦虑心理、缩短康复周期，是安全有效的。
- 康复护理 /
- 临床护理研究 /
- 肝肿瘤 /
- 肝切除术
Abstract: Objective To evaluate the effect of clinical nursing pathway based on fast-track surgery in perioperative patients with primary hepatic carcinoma (PHC). Methods A total of 87 PHC patients undergoing elective hepatectomy were enrolled, and divided into two groups by admission time, namely the control group (45 cases) and the experimental group (42 cases). The patients in the experimental group participated in clinical nursing pathway (CNP) based on the fast-track surgery while the cases in the control group received traditional perioperative nursing care of hepatectomy. Level of perioperative anxiety and postoperative pain, discomfort and complications, hospital stay, costs and re-admission rate were measured. Results Final analysis included 39 patients in the experimental group and 43 patients in the control group. Compared with the control group, scores of self-rating anxiety scales (SAS) and pain were significantly lower in the experimental group (all P<0.05). No significantly differences between the two groups were observed regarding postoperative discomfort and most of complications,hospitalization expense and re-admission rates (all P>0.05) while pulmonary infection rate was lower and hospital stay was shorter in the experimental group (all P<0.05). Conclusions Application of fast-track nursing pathway in perioperative patients with PHC can reduce operative stress and anxiety, achieve faster recovery,which is safe and effective.
- Rehabilitation nursing /
- Clinical nursing research /
- Liver neoplasms /
- Hepatectomy

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参考文献(17)

Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation [J]. Br J Anaesth, 1997,78(5):606-617.

Ansari D, Gianotti L, Schroder J, et al. Fast-track surgery: procedure specific aspects and future direction [J]. Langenbecks Arch Surg, 2013,398(1):29-37.

Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection [J]. Clin Nutr, 2005,24(3):466-477.

朱桂玲,孙丽波,王江滨,等. 快速康复外科理念与围手术期护理 [J]. 中华护理杂志, 2008,43(3):264-265.

于江琪. 应用临床护理途径对肾移植患者实施健康教育的效果观察 [J]. 护士进修杂志,2009,24(24):2264-2266.

张作记. 行为医学量表手册 [M]. 北京:中华医学电子音像出版社,2005.

李艳华,程黎阳,谢正勇,等. 快速康复外科新理念在结直肠手术中的应用 [J]. 中国现代普通外科进展,2009,12(5):405-407.

Kehlet H. Enhanced recovery after surgery (ERAS):good for now,but what about the future? [J]. Can J Anaesth, 2015,62(2):99-104.

林雪英,何风英,李巧连. 肝癌切除术后胃肠功能恢复的护理干预 [J]. 中国实用护理杂志,2012,28(增刊):65-66.

Chowdhury AH, Lobo DN. Fluids and gastrointestinal function [J]. Curr Opin Clin Nutr Metab Care, 2011,14(5):469-476.

陈海珍,陈建国,张兰凤,等. 肿瘤随访现状与进展 [J]. 中华疾病控制杂志,2015,19(5):517-523.

Andersen J, Hjort-Jakobsen D, Christiansen PS, et al. Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery [J]. Br J Surg, 2007,94(7):890-893.

Walter CJ, Smith A, Guillou P. Perceptions of the application of fast-track surgical principles by general surgeons [J]. Ann R Coll Surg Engl, 2006, 88(2):191-195.

肖静,高月霞,陆青云,等. 6168例肝癌患者住院费用影响因素的通径分析 [J]. 中国卫生经济,2012,31(1):73-75.

Wang LH, Fang F, Lu CM, et al. Safety of fast-track rehabilitation after gastrointestinal surgery: systematic review and meta-analysis [J]. World J Gastroenterol, 2014,20(41):15423-15439.

Kehlet H, Mythen M. Why is the surgical high-risk patient still at risk? [J]. Br J Anaesth, 2011,106(3):289-291.

黄天雯,何翠环,陈晓玲,等. 骨科无痛病房护理工作模式的建立 [J]. 中华护理杂志,2011,46(3):221-224.

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