快速康复外科理念在老年肝癌切除术患者中的应用效果

Effects of fast track surgery as applied in elderly patients with hepatocellular carcinoma undergoing hepatectomy

目的探讨快速康复外科(FTS)理念在老年肝癌切除术患者中的应用效果。方法采用随机数字表法将84例老年肝癌切除术患者分为观察组和对照组,各42例。对照组给予常规护理措施,观察组在对照组的基础上给予FTS理念干预。观察干预后两组患者的临床疗效,比较干预前后两组患者的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分以及术后并发症的发生情况。结果术后,观察组患者的首次排气时间、首次排便时间、首次下床时间、拔引流管时间、首次进水时间及住院时间均短于对照组(P﹤0.05)。干预后,两组患者的SAS、SDS评分均低于本组干预前(P﹤0.05);干预后,观察组患者的SAS、SDS评分均低于对照组(P﹤0.05)。观察组患者的腹胀、恶心呕吐、排便困难和发热的发生率均低于对照组(P﹤0.05)。结论 FTS理念可提高老年肝癌切除术患者的临床疗效,改善其焦虑、抑郁等负性情绪,降低术后并发症的发生率,值得临床推广和应用。

Objective To explore the effects of the concept of fast track surgery(FTS)in elderly patients undergoing hepatectomy for hepatocellular carcinoma.Method A total of 84 elderly cases with hepatocellular carcinoma treated by hepatectomy were included in the analysis as study group and control group using a random number table method,with 42 cases in each,respectively.The control group was given routine nursing care,and the study group was administered with nursing care based on FTS concept in addition to routine interventions.The clinical efficacy after intervention in the two groups were observed,and the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)before and after interventions,as well as the incidence of postoperative complications were compared between the two groups.Result The time to first anal exhaust,time to first defecation,time to ambulation,time of drainage tube removal,time to first water intake and the time of hospitalization in the study group were all shorter compared to control group(P<0.05);after intervention,the SAS and SDS scores in both groups were significantly decreased(P<0.05),and were notably lower in study group versus control group(P<0.05).The incidence of abdominal distension,nausea and vomiting,dyschezia and fever in study group were lower than those in control group(P<0.05).Conclusion The concept of fast track surgery can be applied to elderly patients undergoing hepatectomy to improve clinical efficacy,ameliorating patients’negative emotions such as anxiety and depression,and reducing the incidence of complications.