多学科协作模式下快速康复流程在妇科恶性肿瘤患者中的应用

Application of rapid rehabilitation process under multidisciplinary collaboration mode in gynecologic malignancies patients

目的 探讨多学科协作模式下的快速康复流程在妇科恶性肿瘤患者中的应用效果.方法 采用目的抽样法,将2015年1—12月在江苏省淮安市肿瘤医院住院的妇科恶性肿瘤患者50例设为对照组,将2016年1—12月住院的妇科恶性肿瘤患者50例设为观察组.对照组采用常规的围手术期护理,观察组采用多学科协作模式下的快速康复流程.比较两组患者应激反应、肠蠕动恢复时间、住院时间、并发症发生率及血清前白蛋白变化情况.结果 术前1 h、术后8 h观察组患者心率、收缩压、SAS评分均低于对照组,差异有统计学意义（P〈0.05）.术后2 d、术后7 d观察组患者血清前白蛋白水平高于对照组.术后观察组患者肠蠕动恢复时间、住院时间均短于对照组,差异有统计学意义（P〈0.05）.术后观察组患者并发症发生率低于对照组,差异有统计学意义（P〈0.05）.结论 多学科协作模式下的快速康复流程能有效缓解妇科恶性肿瘤患者应激反应,改善机体营养状况,促进术后康复,降低并发症发生率,值得临床进一步推广.

Objective To discuss the application effects of rapid rehabilitation process under multidisciplinary collaboration mode in gynecologic malignancies patients. Methods A number of 50 gynecologic malignancies patients hospitalized in our hospital from January to December 2015 were assigned as control group and received perioperative routine care. Another 50 gynecologic malignancies patients hospitalized between January and December 2016 were assigned as experimental group and received rapid rehabilitation process under multidisciplinary collaboration mode. The stress response, intestinal peristaltic recovery time, hospitalization time, complications and serum albumin changes of patients were compared between the two groups. Results At 1 h before surgery and 8 h after surgery, heart rate （HR）, systolic blood pressure （SBP）, SAS score of patients in the experimental group were lower than the control group, with statistically significant differences between two groups （P〈 0.05）. At 2 d and 7 d after surgery, the serum albumin level of patients in the experimental group was higher than the control group. Intestinal peristalsis recovery time and hospital time of patients in the experimental group were significantly shorter than those in the control group （P〈0.05）. After the surgery, the incidence of complications of patients in the experimental group was lower than the control group. There were statistically significant difference between two groups （P〈0.05）. Conclusions Rapid rehabilitation process under multidisciplinary collaboration mode can effectively alleviate the stress response of gynecological malignant tumor patients, improve the nutritional status of the body, promote postoperative recovery and reduce the incidence of complications, and is worthy of further clinical promotion.