围术期快速康复护理结合临床路径在前列腺癌根治术患者中的应用价值

The application effects of perioperative rapid rehabilitation nursing combined with clinical pathway in patients with prostate cancer undergoing radical prostatectomy

目的探讨围术期快速康复护理结合临床路径在前列腺癌根治术患者中的应用价值。方法选择2017年3月至2019年1月收治的行前列腺癌根治术患者86例为研究对象,采用随机数字法将患者分为对照组和观察组,每组43例。所有患者行经腹膜外腹腔镜前列腺癌根治术治疗,对照组给予围术期常规护理,观察组给予围术期快速康复护理结合临床路径护理。比较2组胃肠功能恢复时间、引流管拔除时间、住院治疗时间及治疗费用,临床并发症,术后生活质量及护理满意度情况。结果观察组胃肠功能恢复时间、引流管拔除时间、住院治疗时间及治疗费用均少于或低于对照组(P<0.05);观察组患者出血、吻合口瘘及尿失禁等并发症发生率低于对照组(P<0.05),2组患者泌尿系统感染发生率比较差异无统计学意义(P>0.05);观察组患者出院后生理、心理、社会及环境功能评分均高于对照组(P<0.05);观察组患者护理满意度97.67%高于对照组81.40%(P<0.05)。结论围术期快速康复护理结合临床路径可有效促进围手术期前列腺癌根治术患者胃肠功能恢复,缩短引流管拔除及住院时间,降低住院治疗费用,提高患者术后生活质量,护理效果显著且满意度高,值得临床应用和推广。

Objective To investigate the application effects of perioperative rapid rehabilitation nursing combined with clinical pathway in patients with prostate cancer undergoing radical prostatectomy.Methods A total of 86 patients who underwent radical prostatectomy in our hospital from March 2017 to January 2019 were enrolled as research objects,who were divided into control group and observation group according to random number method,with 43 cases in each group.All the patients were treated by extraperitoneal laparoscopic radical prostatectomy.Then the patients in control group were given perioperative routine nursing,however,the patients in observation group were given perioperative fast rehabilitation nursing combined with clinical pathway nursing.The recovery time of gastrointestinal function,drainage tube removal time,hospitalization time and treatment cost,clinical complications,postoperative life quality and nursing satisfaction degree were observed and compared between the two groups.Results The recovery time of gastrointestinal function,drainage tube removal time,hospitalization time and treatment cost in observation group were significantly less than those in control group(P<0.05).and the incidence rates of complications including bleeding,anastomotic leakage and urinary incontinence in observation group were significantly lower than those in control group(P<0.05).There was no significant difference in the incidence rate of urinary tract infection between the two groups(P>0.05).Moreover the scores of physiological,psychological,social and environmental functions in observation group were significantly higher than those in control group(P<0.05),and the nursing satisfaction degree of patients in observation group was 97.67%,which was significantly higher than that(81.40%)in control group(P<0.05).Conclusion The perioperative rapid rehabilitation nursing combined with clinical pathway can effectively promote the recovery of gastrointestinal function in patients undergoing radical prostatectomy,shorten the time of drainage tube removal and hospitalization stay,reduce the cost of hospitalization,improve the life quality of patients after operation,and the nursing effects are significant and satisfactory,therefor,it is worthy of clinical application and promotion.