加速康复护理在结肠癌患者围手术期中应用的临床效果

The effect of rapid rehabilitation nursing on perioperative patients with colon cancer

目的：探讨加速康复护理在结肠癌患者围手术期中应用的可行性，为临床护理提供借鉴。方法将90例围手术期的结肠癌患者按随机数字表法分为观察组45例和对照组45例，对照组患者实施传统护理，观察组实施加速康复护理，比较两组患者术后排气时间、排便时间、进食时间、下床时间、尿管及胃管留置时间、总住院时间，观察术后并发症发生及体质量变化情况，出院前进行护理满意度调查。结果观察组排气时间、排便时间、进食时间、下床时间、导尿管留置时间、胃管留置时间、总住院时间分别为（57．6±7．2）h、（76．8±9．6）h、（36．0±6．3）h、（84．3±12．4）h、（50．4±5．2）h、（50．2±6．6）h、（8．4±0．6）d，均优于对照组的（88．8±10．6）h、（113．7±11．3）h、（93．8±8．5）h、（120．4±17．3）h、（101．4±10．6）h、（108．7±14．2）h、（13．2±0．8）d（t ＝6．447、7．004、10．277、7．426、11．303、12．048、5．764，均 P ＜0．01）；观察组术后体质量与术前差异无统计学意义（P ＞0．05），对照组术后7 d、术后30 d 体质量均较术前明显下降，观察组术后7 d、术后30 d 体质量明显高于对照组（t ＝3．657、3．907，均 P ＜0．05）；观察组恶心呕吐、肺部感染、尿路感染的发生率明显低于对照组（χ2＝3．92、6．049、4．232，均 P ＜0．05），护理满意度明显高于对照组（χ2＝4．939，P ＜0．05）。结论加速康复护理有助于围手术期结肠癌患者胃肠功能恢复，减少并发症发生，加速术后康复速度，不影响患者体质量，值得临床推广使用。

Objective To investigate the effect of rapid rehabilitation nursing on perioperative patients with colon cancer,thus to provide reference for clinical care.Methods According to the digital table,90 perioperative patients with colon cancer were randomly divided into observation group and control group,45 cases in each group. The control group was given traditional nursing,the observation group was given rapid rehabilitation nursing.The exhaust time,defecation time,eating time,bed time,indwelling catheter and tube time,hospitalization days were com-pared.The complications and weight changes,made a satisfaction survey of nursing when predischarge were observed. Results The exhaust time,defecation time,feeding time,bed time,catheter indwelling time,gastric retention time, hospitalization days of the observation group were （57.6 ±7.2）h,（76.8 ±9.6）h,（36.0 ±6.3）h,（84.3 ±12.4）h, （50.4 ±5.2）h,（50.2 ±6.6）h,（8.4 ±0.6）d,respectively,which were better than those of the control group [（88.8 ±10.6）h,（113.7 ±11.3）h,（93.8 ±8.5）h,（120.4 ±17.3）h,（101.4 ±10.6）h,（108.7 ±14.2）h, （13.2 ±0.8）d]（t =6.447,7.004,10.277,7.426,11.303,12.048,5.764,all P 〈0.01）.The body weight of the observation group was not significantly different compared between before surgery and after surgery（P 〉0.05）,which of the control group after surgery 7d,30d were significantly decreased than before surgery,and the body weight of the observation group after surgery 7d,30d were significantly higher than the control group（t =3.657,3.907,all P 〈0.05）.The incidence rates of nausea and vomiting,pulmonary infection,urinary tract infections of the observation group were significantly lower than those of the control group（χ2 =3.920,6.049,4.232,all P 〈0.05）.The nursing satisfaction was significantly higher than the control group（χ2 =4.939,P 〈0.05）.Conclusion The rapid rehabilita-tion nursing can contribute to recovery of gastrointestinal function,reduce complications,accelerate postoperative recovery rate,does not affect the patients＇weight,and it is worthy of clinical using in the perioperative patients with colon cancer.