食管癌术后鼻胃肠管护理中应用PDCA护理模式对患者胃肠功能恢复的影响

Effect of PDCA Nursing Mode on the Recovery of Gastrointestinal Function in Patients with Nasal Gastrointestinal Tube after Esophageal Cancer Surgery

目的探讨食管癌术后鼻胃肠管护理中应用PDCA循环护理管理模式对患者胃肠功能恢复的影响。方法方便选取2017年8月—2019年2月该院收治的83例食管癌根治术治疗患者,随机分为两组,对照组41例接受常规食管癌根治术围术期护理,观察组42例在对照组基础上实施PDCA循环护理模式干预。比较两组胃肠功能指标、生活质量及不良反应发生情况。结果干预后观察组肠鸣音恢复时间(1.21±0.29)d、肛门排气时间(2.25±0.53)d、饮食恢复时间(2.16±0.65)d及置管时间(3.22±0.24)d均短于对照组,差异有统计学意义(t=3.430、5.610、9.330、2.550,P<0.05)。观察组SF-36生活质量各项目评分中生理职能(76.59±8.35)分、生理机能(68.63±7.25)分、情感职能(75.27±7.49)分、活力(67.46±14.66)分、躯体疼痛(66.25±12.19)分、社会功能(72.56±10.47)分、精神健康(64.30±16.36)分、总体健康(72.48±12.78)分均高于对照组,差异有统计学意义(P<0.05)。观察组术后不良反应发生率为14.29%,低于对照组的39.02%,差异有统计学意义(χ^(2)=6.520,P<0.05)。结论PDCA循环护理模式可有效促进食管癌根治术后患者胃肠功能恢复,降低不良反应发生风险,提高生活质量,值得临床推广。

Objective To explore the effect of PDCA cycle nursing management model on the recovery of gastrointestinal function in patients with postoperative nasal gastrointestinal tube nursing after esophageal cancer.Methods A total of 83 patients undergoing radical esophageal cancer surgery in the hospital from August 2017 to February 2019 were conveniently selected,they were randomly divided into two groups.41 patients in the control group received routine perioperative care for radical esophageal cancer,and 42 patients in the observation group implemented PDCA cycle nursing mode intervention on the basis of group.The gastrointestinal function indexes,quality of life and the occurrence of adverse reactions were compared between the two groups.Results After the intervention,the recovery time of bowel sounds in the observation group was(1.21±0.29)d,the time of anal exhaust(2.25±0.53)d,the time of diet recovery(2.16±0.65)d,and intubation time(3.22±0.24)d were all shorter than the control group,the difference was statistically significant(t=3.430,5.610,9.330,2.550,P<0.05).In the SF-36 quality of life of the observation group,scores of physiological function(76.59±8.35)points,physiological function(68.63±7.25)points,emotional function(75.27±7.49)points,vitality(67.46±14.66)points,physical pain(66.25±12.19)points,social function(72.56±10.47)points,mental health(64.30±16.36)points,and overall health(72.48±12.78)points were all higher than those of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative adverse reactions in the observation group was 14.29%,which was lower than 39.02%in the control group,the difference was statistically significant(χ^(2)=6.520,P<0.05).Conclusion The PDCA cycle nursing model can effectively promote the recovery of gastrointestinal function in patients after radical resection of esophageal cancer,reduce the risk of adverse reactions,and improve the quality of life.It is worthy of clinical promotion.