快速康复外科理念指导下的护理措施在腹腔镜下前列腺癌根治术患者围术期的应用

Application of FTS concept-guided measures in perioperative care in laparoscopic radical prostatectomy

目的探讨前列腺癌根治术患者围术期采用快速康复外科(FTS)理念指导下的护理措施的有效性和安全性。方法选取2014年10月至2016年11月间同济大学附属第十人民医院收治的134例前列腺癌患者,采用随机数字表法分为研究组76例和对照组58例。研究组患者采用FTS理念指导的护理措施,对照组患者采用常规护理方法,比较两组患者术后营养补液总量、导尿管拔除时间、进食时间、创面引流量、术后首次排气和排便时间、术后下床活动时间及泌尿系统感染等并发症发生情况。结果干预后,研究组患者术后住院时间、术后首次排气和排便时间均短于对照组,差异均有统计学意义(均P<0.05)。干预后,研究组患者术后营养补液量少于对照组,术后进半流质时间、导尿管留置时间和术后下床活动时间均短于对照组,差异均有统计学意义(均P<0.05)。研究组患者术后创面引流量为(125.13±72.58)ml,对照组患者为(132.53±93.64)ml,两组比较,差异无统计学意义(P>0.05)。干预后,两组患者均发生泌尿系统感染、发热、腹胀和恶心呕吐等并发症,但并发症发生率比较,差异无统计学意义(P>0.05)。结论前列腺癌根治术患者围术期采用快速康复外科理念指导下的护理措施,可减少首次排气和排便时间,缩短住院时间,胃肠功能恢复明显加快,值得临床推广。

Objective To discuss the clinical efficacy and safety of fast track surgery（ FTS） concept-guided measures in perioperative care in laparoscopic radical prostatectomy. Methods To select 134 patients with prostate cancer treated at Shanghai Tenth People＇s Hospital Subordinated to Tongji University between October 2014 and November 2016. They were divided them into a research group（ 76 patients）and a control group（ patients）. The research group received FTS concept-guided nursing in perioperative care and the control group received traditional nursing. The total nutrition rehydration,time to extubation,time to meal,volume of drainage,postoperative exhaust time,postoperative offbed activity time,and incidence of complications were compared between the two groups. Results The length of stay,first exhaust time,first defecation time was shorter in the research group than in the control group after the intervention（ all P〈 0. 05）. The total nutrition rehydration,semifluid time after operation,catheter indwelling time and postoperative off-bed activity time was shorter in the research group than in the control group（ all P〈 0. 05）. There was no statistical difference in volume of drainage between the research group（ 125. 13 ±72. 58） ml and the control group（ 132. 53 ± 93. 64） ml（ P〉 0. 05）. There was no statistical difference in the incidence of complication including urinary system infection,fever,abdominal distension,nausea and vomiting which occurred in the both groups（ P〉 0. 05）. Conclusion The FTS concept-guided nursing can reduce first exhaust and defecation time as well as lenth of hospital stay,and prpmote the quick recovery of gastrointestinal function and is worthy of clinical popularization.