加速康复外科护理在原发性肝癌患者肝脏部分切除手术中的应用

The applications of accelerate recovery surgical care in patients with primary liver partial resection surgery

目的 探讨加速康复外科护理对原发性肝癌患者肝脏部分切除术预后及并发症的影响.方法 选取该院2016年1~6月收治的50例原发性肝癌行肝脏部分切除手术患者为研究对象,根据随机数字表将患者分为观察组（n=25）及对照组（n=25）,对照组采用常规性护理,观察组围手术期采用加速康复外科护理,比较两组患者手术情况、术后康复、炎症反应及并发症发生情况.结果 观察组术中出血量少于对照组（P〈0.05）,术后疼痛评分（VAS）低于对照组（P〈0.05）,患者肠道通气时间、恢复谱食时间、放置腹腔引流管时间、血清胆红素恢复正常时间及平均住院时间短于对照组（P〈0.05）.观察组术后第3天血清C反应蛋白（CRP）、白细胞介素-6（IL-6）低于对照组（P〈0.05）,而补体C3水平高于对照组（P〈0.05）.观察组术后并发症发生率低于对照组（P〈0.05）,而患者满意率高于对照组（P〈0.05）.结论 加速康复外科护理可有效减轻原发性肝癌患者肝脏部分切除术患者术后炎症反应,降低患者术后并发症发生率,促进患者术后康复,提高患者满意度.

Objective To explore the applications of accelerate recovery surgical care in patients with primary liver partial resection surgery.Methods A total of 50 patients with primary liver cancer patients undergoing partial hepatectomy line were divided into observation group（n=25） and control group （n=25） from January to June 2016.The control group were applicated with conventional perioperative nursing,while the observation group were applicated with perioperative fast track surgery treatments.The postoperative rehabilitation,inflammation and occurrence of complications of the two groups were compared.Results The blood loss of the observation group was less than that of the control group （P〈0.05）,the postoperative pain score （VAS） was lower than that of the control group （P〈0.05）,patients with intestinal ventilation time,recovery time food spectrum,shunt placement time,serum bilirubin returned to normal and the average hospital stay was shorter than that of the control group （P〈0.05）.The levels of postoperative observation group serum C-reactive protein （CRP）,interleukin-6 （IL-6） were lower than the control group （P〈0.05）,and the level of C3 was higher than that of the control group （P〈0.05）.The incidence of postoperative complications in the observation group was lower than that of the control group （P〈0.05）,while patient satisfaction rate was higher than that of the control group（P〈0.05）.Conclusions Accelerated rehabilitation surgical nursing can reduce the partial liver resection in patients with primary postoperative inflammation,reduce the incidence of postoperative complications in patients after surgery,promote the rehabilitation of patients and improve the patients＇ satisfaction.