医护一体化模式在胸腹腔镜联合食管癌根治术围手术期的应用

Clinical effect of all-in-one nursing intervention to promote the combined thoracoscopic and laparoscopic esophagectomy for esophageal cancer patients' degree of satisfaction and recovery

目的探讨医护一体化护理模式在胸腹腔镜联合食管癌根治术患者围手术期的干预效果。方法选取接受联合腔镜食管癌根治术患者102例,分为对照组40例,采用常规流程进行围手术期诊疗护理;观察组62例,在对照组基础上围手术期采用医护一体化护理模式干预处理。比较分析两组患者的护理效果。结果在医护工作满意度方面:观察组入院接待、健康教育、康复指导得分均高于对照组,差异有统计学意义(P<0.05),两组患者对服务态度、护理技术得分差异无统计学意义。在术后恢复及主要并发症方面:观察组术后排气或排便时间、拔除胸腔引流管时间、住院时间较对照组明显减少,且均差异有统计学意义(P<0.05),两组患者术后胃肠减压引流量差异无统计学意义;观察组和对照组术后主要并发症的发生率分别为9.7%和25.0%,差异有统计学意义(P<0.05)。结论实施医护一体化工作模式在胸腹腔镜联合食管癌根治术患者中有利于提高患者对医护工作的满意度,实现快速康复,降低术后并发症发生率。

Objective To study the clinical effect of all-in-one nursing intervention to promote the combined thoracoscopic and laparo-scopic esophagectomy for esophageal cancer patients′degree of satisfaction and recovery.Methods A hundred and two patients with esophageal carcinoma who had combined thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma from January to December 2013 were enrolled in this study.Sixty-two cases undergoing surgery from June to December 2013 were assigned into the research group and received the all-in-one nursing intervention during perioperative period,while another 40 cases undergoing surgery from January to May were in the control group and received conventional nursing.Degree of patients′satisfaction with nursing work, recovery after surgery and the incidence of complication were compared between the two groups.Results After application of the all-in-one nursing intervention,degree of patients′satisfaction with nursing work was improved greatly.The difference was statistically significant（P 〈0.05）.There were no significant differences in service and nursing techniques.The exsufflation time or defecation time, time for removing pleural cavity drainage tube and hospital stay were all shorter in the research group than in the control group,and the differences were statistically significant（P 〈0.05）.There was no significant difference in drainage of gastrointestinal decompression. The incidence rate of postoperative complication was 9.7% in the research group and 25.0% in the control group,and the difference was statistically significant.Conclusions All-in-one nursing intervention can promote the esophageal cancer patients′satisfaction with nursing work,achieve quick recovery and reduce the rate of postoperative complication.