基于集束化护理的ERAS护理对结直肠肿瘤切除术患者术后恢复及预后的影响

Effect of enhanced recovery after surgery nursing based on cluster nursing on postoperative recovery and prognosis of patients with colorectal tumor resection

目的探讨基于集束化护理的加速康复外科(ERAS)护理对结直肠癌肿瘤切除术患者术后恢复及预后的影响。方法选择2019年10月至2020年10月在河南省肿瘤医院行结直肠肿瘤切除术患者90例为研究对象,采用随机数表法分为观察组和对照组各45例。对照组患者采用常规护理,观察组患者采用基于集束化护理的ERAS护理。比较两组患者术后恢复情况,以及护理前后的白细胞介素-6 (IL-6)肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平、健康调查简表(SF-36)和并发症发生情况。结果术后,观察组患者的进食、排气、排便、下床活动、住院时间分别为(2.28±0.41) d、(1.52±0.31) d、(2.61±0.41) d、(1.19±0.21) d、(5.09±0.61) d,明显短于对照组的(3.21±0.39) d、(2.12±0.51) d、(3.28±0.69) d、(2.09±0.38) d、(6.28±0.58) d,差异均有统计学意义(P<0.05);护理后,两组患者的CRP、TNF-α、IL-6表达水平均降低,且观察组分别为(32.13±4.19) mg/L、(19.21±2.19) ng/L、(51.18±3.65) ng/L,明显低于对照组的(41.98±5.11) mg/L、(23.65±3.22) ng/L、(62.12±3.91) ng/L,差异均有统计学意义(P<0.05);护理后,两组患者的躯体功能、物质生活、社会功能、精神健康等评分均升高,且观察组分别为(65.12±6.98)分、(69.12±4.77)分、(68.22±5.1)分、(73.24±5.98)分,明显高于对照组组的(56.12±5.77)分、(58.12±5.11)分、(60.98±4.94)分、(65.31±4.88)分,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为6.67%,明显低于对照组的22.22%,差异有统计学意义(P<0.05)。结论基于集束化护理的ERAS护理可有效促进结直肠肿瘤切除术患者术后恢复,抑制炎症因子表达,提高生活质量,减少并发症,临床上可推广应用。

Objective To explore the effect of enhanced recovery after surgery(ERAS) nursing based on cluster nursing on postoperative recovery and prognosis of patients with colorectal cancer after tumor resection.Methods Nenety patients who underwent colorectal tumor resection in Henan Cancer Hospital from October 2019 to October 2020 were selected as the research objects. They were randomly divided into observation group and control group, with 45 cases in each group. The patients in the control group received routine nursing, and the patients in the observation group received ERAS nursing based on cluster nursing. The postoperative recovery, interleukin-6(IL-6),tumor necrosis factor-α(TNF-α), C-reactive protein(CRP) level, health survey summary(SF-36) before and after nursing, and complications were compared between the two groups. Results After operation, the time of eating, exhausting, defecating, getting out of bed activities, and hospitalization in the observation group were(2.28 ± 0.41) d,(1.52 ± 0.31) d,(2.61 ± 0.41) d,(1.19 ± 0.21) d, and(5.09 ± 0.61) d, respectively, which were significantly shorter than(3.21±0.39) d,(2.12±0.51) d,(3.28±0.69) d,(2.09±0.38) d, and(6.28±0.58) d in the control group(P<0.05);after nursing, the expression levels of CRP, TNF-α, and IL-6 in the two groups were decreased, and levels in the observation group were(32.13 ± 4.19) mg/L,(19.21 ± 2.19) ng/L,(51.18 ± 3.65) ng/L, significantly lower than(41.98 ± 5.11) mg/L,(23.65±3.22) ng/L,(62.12±3.91) ng/L in the control group(P<0.05);after nursing, the scores of physical function, material life, social function, and mental health of the two groups were increased, and scores in the observation group were(65.12 ± 6.98) points,(69.12 ± 4.77) points,(68.22 ± 5.1) points,(73.24 ± 5.98) points, significantly higher than(56.12±5.77) points,(58.12±5.11) points,(60.98±4.94) points,(65.31±4.88) points in the control group(P<0.05). The incidence of complications in the observation group was 6.67%, which was significantly lower than 22.22% in the control group(P<0.05). Conclusion ERAS nursing based on cluster nursing can effectively promote the postoperative recovery of patients with colorectal tumor resection, inhibit the expression of inflammatory factors, improve the quality of life and reduce complications, which can be widely used.