无瘤护理技术在腹腔镜直肠癌根治术中的应用价值

The value of no-tumor nursing in laparoscopic radical resection of rectal cancer

目的探讨无瘤护理技术在腹腔镜直肠癌根治术中的应用价值。方法纳入120例腹腔镜直肠癌根治术患者作为研究对象,随机分为两组,每组各60例,对照组术中行常规护理配合,观察组根据无瘤护理理念进行护理配合。比较两组手术基本情况(手术时间、术中出血量、淋巴结清扫数目、住院时间)、术后并发症发生率及术中腹腔肿瘤细胞种植率和术后复发转移情况。结果两组手术时间、术中出血量、淋巴结清扫数目、住院时间及术后并发症发生率差异均无统计学意义(均P>0.05)。观察组腹腔肿瘤细胞种植率低于对照组,差异有统计学意义(P<0.05)。观察组术后3年内发生远处转移3例,发生率5.00%,对照组8例发生远处转移,1例切口种植,发生率为15.00%。两组术后无事件生存率差异无统计学意义(Log-rank χ~2=3.338,P=0.068)。结论无瘤护理技术用于腹腔镜直肠癌手术有助于降低腹腔肿瘤细胞种植率,令患者获益。

Objective To investigate the clinical value of no-tumor nursing in laparoscopic radical resection of rectal cancer. Methods 120 patients with rectal cancer who underwent laparoscopic radical resection were included in the study and were randomly assigned into two groups, with 60 cases in each group. The control group received routine nursing and the treatment group received nursing adopting the concept of non-tumor nursing. Indices related to operation（duration, amount of blood loss, the number of lymph node dissection, and duration of hospitalization）, postoperative complications, implantation metastasis, and metastasis were compared between the two groups. Results There were no significant difference in duration of operation, amount of blood loss, the number of lymph node dissection, duration of hospitalization, and incidence of postoperative complications between the two groups（P〈0.05）. Implantation metastasis occurred significantly less in the treatment group than in the control group（P〈0.05）. Three patients in the treatment group had distant metastasis 3 years after operation and the incidence rate was 5.00%. Eight patients in the control group had distant metastasis, one had incision implantation metastasis and the incidence was 15.00%. There was no difference in event-free survival at 3-year postoperative between the two groups（Log-rank χ~2= 3.338, P = 0.068）. Conclusion No-tumor nursing can lower the incidence of implantation metastasis in laparoscopic surgery for rectal cancer. It is beneficial for patients.