院外延续管理对食管癌术后患者的影响

Effect of out-of-hospital continuous management on patients with esophageal cancer

目的探究院外延续管理对食管癌患者自我健康管理能力、吻合口狭窄发生情况、营养状况及生活质量的影响。方法按照干预方法的不同将210例行手术治疗的食管癌患者分为院外延续管理组(n=100)和常规干预组(n=110),其中,常规干预组接受常规干预,院外延续管理组接受常规干预+院外延续管理。比较两组患者的自我健康管理能力、吻合口狭窄发生情况、营养状况[清蛋白(Alb)水平、血红蛋白(Hb)水平、体质量]和生活质量。结果出院1、2、3个月时,院外延续管理组患者的自我健康管理能力得分均高于常规干预组患者(P﹤0.05)。院外延续管理组患者的吻合口狭窄发生率为11.00%(11/100),明显低于常规干预组患者的28.18%(31/110)(P﹤0.01)。出院3个月后,院外延续管理组患者的Alb、Hb水平均明显高于常规干预组患者,体质量明显重于常规干预组患者(P﹤0.01)。出院3个月后,院外延续管理组患者的消化功能、精神心理、躯体功能、社会活动及生活质量总分均明显高于常规干预组患者(P﹤0.01)。结论院外延续管理可有效提升食管癌患者的自我健康管理能力,降低吻合口狭窄发生率,改善患者的营养状态,提高其生活质量。

Objective To explore the effect of out-of-hospital continuous management on ability of self-health management,incidence of anastomotic stricture,nutritional status and quality of life in patients with esophageal cancer.Method 210 patients with esophageal cancer who underwent surgery were divided into the out-of-hospital continuous management group(routine intervention+out-of-hospital continuous management,n=100)and routine intervention group(routine intervention,n=110).The ability of self-health management,incidence of anastomotic stricture,nutritional status[albumin(Alb)level,hemoglobin(Hb)level,body weight]and quality of life were compared between the two groups.Result The score of ability of self-health management in the out-of-hospital continuous management group was significantly higher than that in the routine intervention group 1 month,2 months and 3 months after discharge(P<0.05).The incidence rate of anastomotic stenosis in the out-of-hospital continuous management group(11.00%,11/100)was significantly lower than that in the routine intervention group(28.18%,31/110)(P<0.05).3 mounths after discharge,the levels of Alb and Hb,body weight,socres of digestion,mental-psychological status,physical function,social activity and quality of life were significantly higher in the out-of-hospital continuous management group than those in the routine intervention group(P<0.01).Conclusion The out-of-hospital continuous management can effectively improve the selfhealth management level of esophageal cancer patients,reduce the incidence of anastomotic stricture,and improve the nutritional status and quality of life.