快速康复护理在肝脏切除术患者中的应用

Application of Rapid Rehabilitation Nursing in Patients Undergoing Liver Resection

目的比较快速康复护理和常规护理在接受肝部分切除术的肝癌患者中的短期疗效。方法 2016年5月—2018年4月间方便选取80例患有肝癌并接受手术治疗的患者进行随机分组:A组(n=40)采用快速康复护理方案,B组(n=40)采用常规护理方案。研究主要结局指标是使用Clavien Dindo分类记录手术相关并发症的发生率。次要结果指标是C反应蛋白(C-reactive protein,CRP)、住院时间、术后第5天肝功能状态和舒适状况。结果与B组相比,A组的鼻胃管和腹腔引流管持续时间、第一次肠胃胀气时间和住院时间均显著缩短(z/t=18.941、9.662、5.401、3.063,P<0.05),而GCQ测量值显著提高(t=4.984,P<0.01),并且在肝部分切除术后第1、3、5天,A组CRP水平均显著低于B组(t=2.836、11.907、9.139,P<0.05)。采用Clavien Dindo手术并发症分类法,B组总并发症(46.0%vs 30.0%),(χ^2=4.178,P<0.05)和I级并发症(25.0%vs 13.0%)(P<0.05)发生率明显高于A组。结论对于接受肝部分切除术的肝癌患者,快速康复护理方案是安全且有效的。

Objective To compare the short-term effects of rapid rehabilitation nursing and routinal nursing in liver cancer patients undergoing partial hepatectomy.Methods Convenient select From May 2016 to April 201880 patients with liver cancer who underwent surgical treatment were randomly divided into groups:group A(n=40)used rapid rehabilitation care plan,group B(n=40)used routinal care program.The main outcome indicator of the study was to record the incidence of surgery-related complications using Clavien Dindo classification.The secondary outcome indicators were C-reactive protein(CRP),length of hospital stay,liver function status and comfort status on the 5 th day after surgery.Results Compared with group B,the duration of nasogastric tube and abdominal drainage tube,first flatulence,and hospital stay in group A were significantly shorter(z/t=18.941,9.662,5.401,3.063,P<0.05),while GCQ measured value was significantly improved(t=4.984,P<0.01),and on the 1,3,and 5 days after partial hepatectomy,the CRP level of group A was significantly lower than that of group B(t=2.836,11.907,9.139,P<0.05).According to the classification of Clavien Dindo surgical complications,the incidence of total complications in group B(46.0%vs 30.0%)(χ~2=4.178,P<0.05)and grade I complications(25.0%vs13.0%)(P<0.05)was significantly higher than group A.Conclusion For liver cancer patients undergoing partial hepatectomy,the rapid rehabilitation nursing program is safe and effective.