临床护理路径在腹腔镜胃癌根治术中的应用效果

Application of clinical nursing pathway in laparoscopic radical gastrectomy for gastric cancer

目的探讨临床护理路径对腹腔镜胃癌根治术患者围术期机体免疫及胃肠功能恢复的影响。方法 选取2017 年1 月至2018 年1 月来本院行腹腔镜胃癌根治术患者82 例,按随机数字表法分为两组,各41 例。对照组实施常规护理,观察组实施临床护理路径,比较两组肛门排气时间、肠鸣音恢复时间、开始进食时间及住院时间,并观察两组干预前后机体免疫功能变化,包括CD3+、CD4+、CD8+、CD4+/CD8+。结果 观察组肛门排气时间、肠鸣音恢复时间、开始进食时间及住院时间分别为(32.16±2.69)h、(23.91±2.88)h、(6.12±1.03)h、(8.56±1.98)d,均短于对照组(44.85±4.27)h、(31.23±3.74)h、(9.76±1.54)h、(13.84±3.26)d,差异均有统计学意义(均P < 0.05);干预后,两组患者CD3+、CD8+水平比较,差异均无统计学意义(均P > 0.05),但观察组CD4+、CD4+/CD8+水平分别为(49.72±3.25)%、(1.58±0.67)%,均高于对照组(37.84±2.29)%、(1.18±0.41)%,差异均有统计学意义(均P < 0.05)。结论 开展腹腔镜胃癌根治术的同时,配合实施临床护理路径,可促进患者胃肠功能恢复,同时可改善患者机体免疫力。

Objective To explore the effect of clinical nursing pathway on perioperative immunity and gastrointestinal function recovery in patients undergoing laparoscopic radical gastrectomy. Methods 82 patients who underwent laparoscopic radical gastrectomy at our hospital from January, 2017 to January, 2018 were divided into a control group (n=41, routine nursing) and an observation group (n=41, clinical nursing pathway). The anal exhaust time, bowel sound recovery time, time for starting to eat, and hospitalization time were compared between the two groups. The CD3+, CD4+, CD8+, and CD4+/CD8+ were observed before and after intervention. Results The anal exhaust time, the recovery time of bowel sounds, the time for intaking food, and the hospitalization time were (32.16±2.69)h,(23.91±2.88)h,(6.12±1.03)h, and (8.56±1.98)d in the observation group, and were (44.85±4.27)h,(31.23±3.74)h,(9.76±1.54)h, and (13.84±3.26)d in the control group (all P < 0.05). After the intervention, the levels of CD4+ and CD4+/CD8+ were higher than in the control group [(49.72±3.25)% vs.(37.84±2.29)%,(1.58±0.67)% vs.(1.18±0.41)%, all P < 0.05]. Conclusion Laparoscopic radical gastrectomy combined with clinical nursing pathway can promote the recovery of gastrointestinal function and improve the immunity.