快速康复外科护理路径在腹腔镜胃癌根治术围术期护理中的应用

Application of fast track surgery pathways in perioperative nursing care in laparoscopy-assisted radical gastrectomy

目的探讨临床护理路径(CNP)和快速康复外科理念(FTS)在腹腔镜胃癌根治术围术期护理中的应用效果。方法选取2014年3月至2017年2月间四川省南充市中心医院嘉陵院区收治的156例行腹腔镜胃癌根治术的胃癌患者,按照不同的护理方式分为观察组与对照组,每组78例。观察组患者采用常规围术期护理联合临床护理路径和快速康复护理,对照组患者采用常规围术期护理,比较两组患者术中出血量、手术时间、肛门首次排气时间、术后首次进食时间、住院时间及并发症发生情况。结果两组患者围术期术中出血量和手术时间比较,差异无统计学意义(P>0.05)。观察组患者围术期肛门首次排气时间、住院时间、术后首次进食时间和疼痛视觉模拟评分均明显低于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者健康知识知晓评分和护理满意度均高于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者术后并发症发生率低于对照组患者,差异有统计学意义(P<0.05)。结论在腹腔镜胃癌根治术患者围术期联合CNP和FTS进行术后护理,可有效减轻患者手术的应激和术后并发症,提高患者主动参与能力及相关知识的认知程度,对促进患者术后快速康复及改善生活质量有积极意义。

Objective To observe the efficacy of clinical nursing pathways（CNP） and fast track surgery（FTS） in perioperative nursing in laparoscopy-assisted gastrectomy for gastric cancer. Methods A total of 156 patients with gastric cancer undergoing laparoscopy-assisted radical gastrectomy at Nanchong Central Hospital Jialing Campus from March 2014 to February 2017 were selected. According to different nursing methods,the patients were divided into an observation group and a control group with 78 patients in each group. The observation group was given fast track surgery pathways based nursing combined with routine nursing and the control group was given routine care. The clinical data of selected patients was retrospectively analyzed. Intraoperative blood loss,operation time,exhaust time,eating time,length of stay and incidence of the complications and visual analogue scale（VAS） score were observed in the two groups.Results There was no significant difference in the operation time and operation time between the two groups（P〉0. 05）. The exhaust time,length of hospitalization stay,eating time and VAS score were significantly lower in the observation group than in the control group（all P〈0. 05）. The scores of health knowledge awareness and satisfaction with nursing were significantly higher in the observation group than in the control group（all P〈0. 05）. The incidence of postoperative complications was significantly lower in the observation group than in the control group（P〈0. 05）. Conclusion The combination CNP and FTS in laparoscopy-assisted radical gastrectomy for gastric cancer can effectively reduce the stress and postoperative complications,improve the ability of active participation and health knowledge awareness,which has a significantly positive significance in promoting postoperative rehabilitation and quality of life.