加速康复外科理念下集束化干预在腹腔镜胃癌根治术围手术期管理中的应用效果

Effect of Cluster Intervention Under the Concept of Enhanced Recovery After Surgery in the Perioperative Management of Laparoscopic Radical Gastrectomy

目的探讨加速康复外科(ERAS)理念下集束化干预在腹腔镜胃癌根治术围手术期管理中的应用效果。方法回顾性分析河南省肿瘤医院2020年1月至2021年1月收治的176例接受腹腔镜胃癌根治术治疗的患者的临床资料。根据干预方式将患者分为A组(81例)和B组(95例)。A组患者接受常规护理。B组患者接受ERAS理念下集束化干预。比较两组手术相关指标。分别于干预前后采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评估患者的生存质量。比较两组干预前后焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。比较两组并发症发生率。结果B组鼻肠管拔除时间、术后住院时间、肠鸣音恢复时间、术后首次下床活动时间、术后首次进食时间、术后肠外营养使用时间均短于A组(P<0.05)。干预后,两组WHOQOL-BREF各项评分均升高,B组WHOQOL-BREF各项评分高于A组(P<0.05)。干预后,两组SAS、SDS评分均下降,B组SAS、SDS评分低于A组(P<0.05)。B组患者并发症发生率较A组低(P<0.05)。结论基于ERAS理念的集束化干预有助于腹腔镜胃癌根治术患者的围手术期管理,能够提升患者的生活质量并缩短康复进程,改善负面情绪,减少并发症。

Objective To explore the effect of cluster intervention under the concept of enhanced recovery after surgery(ERAS)in the perioperative management of laparoscopic radical gastrectomy.Methods A retrospective analysis of the clinical data of 176 patients who underwent laparoscopic radical gastrectomy in Henan Cancer Hospital from January 2020 to January 2021.According to the intervention method,the patients were divided into group A(81 cases)and group B(95 cases).The patients in group A received routine care.The patients in group B received cluster intervention under the concept of ERAS.The operation-related indicators in the two groups were compared.World Health Organization quality of life-BREF(WHOQOL-BREF)was used to assess the quality of life of the patients before and after intervention.The scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)of the two groups before and after intervention were compared.The incidence of complications between the two groups was compared.Results The removal time of naso-intestinal tube,postoperative hospital stay,bowel sound recovery time,the first postoperative time to get out of bed,postoperative first meal time and postoperative parenteral nutrition use time in group B were shorter than those in group A(P<0.05).After intervention,the scores of WHOQOL-BREF in the two groups increased,and the scores of WHOQOL-BREF in group B were higher than those in group A(P<0.05).After intervention,the scores of SAS and SDS in the two groups decreased,and the scores of SAS and SDS in group B were lower than those in group A(P<0.05).The incidence of complications in group B was lower than that in group A(P<0.05).Conclusion The cluster intervention based on the concept of ERAS is helpful for the perioperative management of patients undergoing laparoscopic radical gastrectomy,which could improve the quality of life of patients,shorten the rehabilitation process,improve negative emotions,and reduce complications.