快速康复教育路径在胰腺癌患者围术期中的应用

Application of fast track education path in perioperative period of pancreatic cancer patients

目的探讨快速康复教育路径在胰腺癌围术期患者中的研究应用。方法选取2012年6月～2013年9月在河北北方学院附属第一医院行胰腺癌手术治疗的患者60例，按随机数字表法分为实验组和对照组，各30例，实验组采用快速康复教育路径表的形式行护理宣教，对照组采用传统方法行健康宣教。比较分析两组患者的平均住院时间、首次排气、下床、排便时间、营养状况、术后并发症、满意度、健康宣教掌握情况；记录患者术后1～5d视觉模拟评分（VAS）情况；检测患者术前及术后营养状况指标等方面。结果与对照组相比，实验组术后患者住院总时间明显缩短，首次排气、下床时间及排便时间提前，总体并发症发生率明显降低（P〈0．05）；实验组术后5d前白蛋白、转铁白蛋白水平明显高于对照组（P〈0．01）；实验组于术后3、4、5dVAS评分值明显低于对照组评分（P〈0．05）；实验组在满意度、健康教育掌握情况的评分明显高于对照组（P〈0．05）。结论快速康复教育路径体现了人性化、个体化护理的理念，缩短了住院时间，改善了术后营养状况，降低了术后并发症，改善了患者术后生活质量，提高了患者的满意度，从而提升了胰腺癌患者围术期治疗的护理质量。

Objective To investigate the influence of fast track surgery on patients with pancreatic ancer in perioperative period. Methods 60 patients undergoing pancreatic cancer operation in the First Affiliated Hospital of Hebei North University from June 2012 to September 2013 were divided into experimental group and control group according to random number table, with 30 cases in each group. Patients in experimental group were processed by fast-track surgery concept, while patients in control group were processed by routine nursing method. The average time of hospital, first-exhaust time, getting up of bed time, first-defecation time, nutritional status, postoperative complications, satisfaction and grasp situation of health education were compared between two groups, VAS score of postoperative 1-5 d and nutrition index between two groups were recorded and evaluated. Results Compared with control group, postoperative hospital time was significantly shortened, first-exhaust and defecation time, bed time were earlier, and overall incidence of complications were significantly lower in experimental group （P 〈 0.05）; PAB and TRF level in experimental group were higher than those in control group （P 〈 0.01）. VAS score of postoperative 3, 4 and 5 d in experimental group were lower than those in control group （P 〈 0.05）. The satisfaction and health education were more superior to those in control group （P 〈 0.05）. Conclusion Fast track surgery education embodies the humanized and individualized nursing concept, shortens the length of hospital stay, improves postoperative nutritional status, reduces the postoperative complications, improves the patients＇ postoperative quality of life and the patients＇ satisfaction in order to improve the perioperative nursing quality.