综合干预措施对肾癌术后患者胃肠道功能恢复的影响

Effect of comprehensive intervention on recovery of gastrointestinal function in patients with renal cancer after operation

目的:探讨综合干预对肾癌术后患者胃肠道功能恢复的影响.方法:选取2013-01/2014-10于天津医科大学第二医院泌尿外科收治的接受手术治疗98例肾癌患者为研究对象,按照随机数字表分为观察组和对照组,两组各49例.对照组患者术后进行常规的胃肠道干预,观察组在此基础上给予足三里穴位按摩、白细胞增长仪穴位电疗、床上胃肠功能锻炼操、复方丁香开胃贴药丸敷脐等综合干预措施,比较两组的胃肠功能恢复指标、胃肠道并发症发生率、术后恢复指标、患者对护理过程的满意度.结果:观察组的肠鸣音恢复时间(15.95 h±3.73 h vs 18.74 h±4.16 h,P<0.001)、首次肛门排气时间(27.84 h±6.07 h vs 38.29 h±14.72 h,P<0.001)、术后首次排便时间(46.08 h±7.84 h vs 61.23 h±14.10 h,P<0.001)、恶心呕吐(18.4%vs 40.8%,P<0.05)、腹胀(16.3%vs 34.7%,P<0.05)、嗳气(12.2%vs 30.6%,P<0.05)等各胃肠道并发症的发生率、普通饮食时间(2.60 d±1.47 d vs 3.88 d±1.91 d,P<0.001)、切口愈合时间(6.62 d±2.54 d vs8.34 d±2.31 d,P<0.001)、住院时间(10.69 h±2.83 h vs 13.45 h±4.71 h,P<0.001)均显著少于对照组,且30 h内排气人数比例(65.3%vs 34.7%,P<0.01)显著多于对照组.观察组患者的总满意率均显著优于对照组(79.3%vs 55.1%,P<0.05).结论:综合干预措施可有效加快肾癌术后患者的胃肠功能的恢复,促进术后康复,提高护理满意度,值得临床推广.

AIM： To investigate the effect of comprehensive intervention on the recovery of gastrointestinal function in patients with renal cancer after operation.METHODS： Ninety-eight patients with renal cancer who underwent surgery from January2013 to October 2014 in Department of UrologySurgery of the Second Hospital of Tianjin Medical were enrolled and randomly divided into an observation group and a control group, with 49 cases in each group.Patients in the control group were given conventional gastrointestinal intervention.Based on it, cases in the observation group were given comprehensive intervention. The gastrointestinal functional recovery indexes,incidences of gastrointestinal complications,postoperative recovery indexes and patients＇ nursing satisfaction were compared between the two groups.RESULTS： The times to recovery of bowel sound（15.95 h ± 3.73 h vs 18.74 h ± 4.16 h, P〈0.001）, first exhaust（27.84 h ± 6.07 h vs 38.29 h± 14.72 h, P〈0.001）, and first defecation（46.08 h ± 7.84 h vs 61.23 h ± 14.10 h, P〈0.001）, the incidences of gastrointestinal complications including nausea and vomiting（18.4% vs40.8%, P〈0.05）, abdominal distension（16.3%vs 34.7%, P〈0.05）, and belching（12.2% vs30.6%, P〈0.05）, the time to ordinary diet（2.60 d ± 1.47 d vs 3.88 d ± 1.91 d, P〈0.001）, wound healing time（6.62 d ± 2.54 d vs 8.34 d ± 2.31 d,P〈0.001）, and hospital stay（10.69 h ± 2.83 h vs 13.45 h ± 4.71 h, P〈0.001） in the observation group were significantly less than those in the control group, and the rate of cases with first exhaust within 30 h was significantly more than that in the control group（65.3% vs 34.7%,P〈0.05）. Patients＇ total satisfactory rate in the observation group was significantly better than that in the control group（79.3% vs 55.1%,P〈0.05）.CONCLUSION： Comprehensive intervention could effectively accelerate the recovery ofpostoperative gastrointestinal function, promote the postoperative recovery and improve nursing satisfaction in patients with renal cancer.