快速康复外科护理在胰十二指肠切除术围手术期的应用

Application of Rapid Rehabilitation Surgical Nursing in Perioperative Period of Pancreatoduodenectomy

目的探讨快速康复外科护理在胰十二指肠切除术围手术期的应用效果。方法选取2018年5月1日-2019年10月31日某院收治的胰头及壶腹周围癌患者106例,所有患者均接受胰十二指肠切除术,根据随机数表法分为FTS组和常规组,各53例,常规组患者采用常规护理措施,FTS组采用快速康复外科理念对围术期进行护理,比较2组患者手术相关指标和血清学指标,并比较2组患者生活质量和并发症发生率,以及患者满意度进行比较。结果FTS组术排气时间(2.34±0.28)天、下床时间(3.86±0.41)天、拔管时间(1.94±0.33)天和住院时间(12.12±2.43)天均明显少于常规组(3.24±0.53、6.28±0.78、3.27±0.58、23.51±2.89)天,差异有统计学意义(t=10.931、7.043、14.510、14.248,P=0.000)。术后3天2组患者血清学指标水平均降低,且FTS组CRP(37.42±4.74)mg/L、AMY(161.34±22.11)U/L、TBIL(22.46±3.38)μmol/L、ALT(52.19±6.07)U/L,且FTS组CRP、AMY、TBIL、ALT降低程度更加明显,差异有统计学意义P=0.00。FTS组社会功能(81.23±8.31)分、物质生活(81.79±8.91)分、躯体功能(79.49±7.25)分、心理功能(78.52±7.83)分等评分明显高于常规组(52.89±5.51、51.67±5.54、52.28±5.34、51.91±5.65)分,差异有统计学意义(t=20.692、20.899、21.999、20.063,P=0.000)。FTS组患者满意度94.34%高于常规组83.02%,差异有统计学意义(χ^(2)=10.241,P=0.006)。FTS组并发症发生率3.77%明显低于常规组18.87%,差异有统计学意义(χ^(2)=6.014,P=0.014)。结论快速康复外科护理在胰十二指肠切除术围手术期的应用效果显著,可促进患者康复,改善患者血清学指标水平,提高患者生活质量,并发症较少,且患者满意度较高,值得临床进一步推广。

Objectives To investigate the application effect of fast recovery surgery(FTS)nursing in perioperative period of pancreatoduodenectomy.Methods Choice in May 1st,2018 to October 31st,2019 of our hospital and the head of pancreas ampulla carcinoma around 106 cases,all patients underwent pancreticoduedenectomy,according to the stochastic indicator method is divided into FTS group and routine group,53 cases,normal group were treated by routine nursing measures,FTS group with rapid rehabilitation surgery concept for perioperative care,compared two groups of patients index and serological index related to the operation,and compare the two groups of patients quality of life and the incidence of complications,patients'satisfaction in the comparison.Results The FTS group had significantly lower exhaust time(2.34±0.28),out of bed time(3.86±0.41),extubation time(1.94±0.33)and hospital stay time(12.12±2.43)than the conventional group,and the differences were statistically significant(T=10.931,7.043,14.510,14.248,P=0.000).Before treatment,there was no significant difference in serological index level between the two groups(P>0.05).After surgery,the serological index level of both groups was decreased,and the degree of CRP,AMY,TBIL and ALT was more significant in the FTS group,with statistically significant differences(P<0.05).The scores of social function,material life,physical function,and psychological function in the FTS group were significantly higher than those in the conventional group,with statistically significant differences(T=20.692,20.899,21.999,20.063,P=0.000).The degree of satisfaction of patients in the FTS group(94.34%)was higher than that in the conventional group(83.02%),with a statistically significant difference(χ^(2)=10.241,P=0.006).The incidence of complications in the FTS group(3.77%)was significantly lower than that in the conventional group(18.87%),with a statistically significant difference(χ^(2)=6.014,P=0.014).Conclusions The application of rapid rehabilitation surgery in perioperative period of pancreaticoduodenectomy had a significant effect,which could promote the rehabilitation of patients,improve the serological level of patients,improve the quality of life of patients,with fewer complications and higher patient satisfaction,and was worthy of further clinical promotion.