快速康复护理在结肠癌伴肝转移综合治疗中的应用

Clinical Application of Fast Track Surgery in colon cancer with liver metastasis of comprehensive treatment

目的比较快速康复护理与常规护理对结肠癌伴肝转移患者康复的效果。探讨快速康复护理在结肠癌伴肝转移综合治疗中的应用意义。方法将湖北省太和医院2007～2009年收治的79例结肠癌伴肝转移行综合治疗患者随机分为实验组45例和对照组34例。分别采用快速康复护理和常规护理,观察术后首次排气排便时间,统计住院时间、治疗费用及术后并发症,评价营养状况等,并随访3年观察残肝癌再发率及3年生存率。结果两组患者均痊愈出院。快速康复护理组与常规护理组相比,术后首次排气排便时间均明显提前,住院费用及住院时间明显减少;快速康复护理组营养风险评分低于常规护理组;快速康复护理组术后并发症风险低于常规护理组;但3年残肝癌再发率及3年生存率无明显差异。结论应用快速康复理念护理肠癌伴肝转移患者是安全、有效的。其护理方案与常规护理方案相比,能快速恢复肠胃功能,减少住院时间及住院费用,改善术后营养状况,降低术后并发症风险,而不影响长期预后。

Objective To investigate the effectiveness of using fast track surgery in comprehensive therapy of colon cancer with liver metastasis.Methods 79 patients of colon cancer with liver metastasis under going colorectal surgery who were come from Taihe Hospital in 2007~2009 were randomly divided into the group of fast tract nursing ( FTN) with 45 patients and the group of conven-tional nursing(CN)with 34 patients.Clinical therapeutic efficacy and complications were compared between the two groups by the postoperative defecate and exhaust time ,the time in the hospital ,the cost of treatment and postoperative complications ,the nutritional status,the rate of recurrence of liver cancer and survival rate in 3 years.Results Two groups of patients were recovered.Compared to the CN group,the time of first exhaust and defecation was advanced.The hospital costs and the time in the hospital of FTN group was reduced.The nutritional status and postoperative complications of FTN group was lower.But the rate of recurrence of liver cancer and survival rate in 3 years has no obvious difference.Conclusion The using of fast track surgery in comprehensive therapy of colon cancer with liver metastasis.is safe and effective.It is clinically feasible to apply the principle of fast t ract surgery to the nursing care of the co lorectal surg er y pat ient s because it can significant ly release pains ,reduce complicat ion rate and accelerate the r ecovery after surgery.The FTN can accelerate the recovery after surgery ,reduce the hospital costs and the time in the hospital ,improve the postoperative nutritional status and reduce the risk of postoperative complications.But the long-term prognosis do not affect.